Independent Exercise Research Articles

Judicial Immunity – A Guarantee of Independence and an Element of Accountability

Abstract The aim of the article is to develop a common understanding of the content of judicial immunity and thus to generate a theory on the application of this legal institution in ensuring and balancing judicial independence and accountability. Neither the separation of powers nor the judicial independence precludes the assessment of a judge’s responsibility for violation of the law, however, it is in the interests of both the state and society to ensure the independent exercise of the judicial function. Therefore, there is a need to strike a balance between the independent exercise of the judicial function and the holding of judges accountable. This balance is ensured by judicial immunity. The research was carried out by using the methods of scientific research customary in legal science: literature studies, analytical, comparative, inductive and deductive research methods. The study reveals the aim of judicial immunity, describes its content focusing on two elements of the judicial immunity: non-liability and inviolability and reveals the specific requirements of judicial immunity. The study confirms that well-regulated and responsibly applied judicial immunity ensures that independence and accountability can be balanced.

Legislative configuration and strength through the idea of Ends Independence

ABSTRACT Prior approaches to evaluating legislative strength cross-nationally have focused on the idea of Means Independence, defined as the procedural autonomy of a legislature. However, expanded Means Independence might not necessarily effect policy effects outside the chief executive’s preference, referred to as Ends Independence. Spatial models estimate the influence of different configurations of legislative processes on Ends Independence. Findings show that an increase in Means Independence does not simultaneously increase Ends Independence. Ends Independence can be guaranteed only when the opposition has the right to propose first, and results are minimally affected by new information updated through the exercise of Means Independence. These findings demonstrate the importance of understanding the overall structure of the legislative process to assess legislative power vis-à-vis an authoritarian executive.

Evaluating multi-channel interaction design for enhancing Pose accuracy in yoga training among visually impaired individuals

Aim: Physical exercise is essential for the physical and mental health of visually impaired people, but they often face challenges such as inaccurate movements, lack of rhythm and difficulty in mastering postures during exercise. This project introduces an assistive device based on a multi-channel interaction design strategy to improve the accuracy of yoga practice for the visually impaired and to enable their independent exercise. Methods: The system uses a 1:1 model combined with an output interaction model. The effectiveness was verified through controlled experiments with unassisted exercise as the control group and yoga-assisted exercise as the experimental group. Improvements in yoga accuracy and product usability were verified using the Assisted Accuracy Scale and the SUS Scale, respectively. Results: The results showed that the multi-channel interaction design significantly improved the accuracy and usability of yoga exercises and enhanced the ability of visually impaired people to exercise independently. Conclusion: Through this project, we hope to replicate this design strategy to help more visually impaired individuals independently perform effective physical exercise at home, in a gym, or in an outdoor space, thereby improving their quality of life and overall health.

An Actively Vision-Assisted Low-Load Wearable Hand Function Mirror Rehabilitation System

The restoration of fine motor function in the hand is crucial for stroke survivors with hemiplegia to reintegrate into daily life and presents a significant challenge in post-stroke rehabilitation. Current mirror rehabilitation systems based on wearable devices require medical professionals or caregivers to assist patients in donning sensor gloves on the healthy side, thus hindering autonomous training, increasing labor costs, and imposing psychological burdens on patients. This study developed a low-load wearable hand function mirror rehabilitation robotic system based on visual gesture recognition. The system incorporates an active visual apparatus capable of adjusting its position and viewpoint autonomously, enabling the subtle monitoring of the healthy side’s gesture throughout the rehabilitation process. Consequently, patients only need to wear the device on their impaired hand to complete the mirror training, facilitating independent rehabilitation exercises. An algorithm based on hand key point gesture recognition was developed, which is capable of automatically identifying eight distinct gestures. Additionally, the system supports remote audio–video interaction during training sessions, addressing the lack of professional guidance in independent rehabilitation. A prototype of the system was constructed, a dataset for hand gesture recognition was collected, and the system’s performance as well as functionality were rigorously tested. The results indicate that the gesture recognition accuracy exceeds 90% under ten-fold cross-validation. The system enables operators to independently complete hand rehabilitation training, while the active visual system accommodates a patient’s rehabilitation needs across different postures. This study explores methods for autonomous hand function rehabilitation training, thereby offering valuable insights for future research on hand function recovery.

A tool for clarifying expectations in undergraduate research experiences.

Articulating clear and achievable expectations is fundamental to both education and organizational management. In this article, we provide a simple intervention for clarifying expectations-and establishing that these expectations have been understood-which proved beneficial both to community college interns and to their internship mentors in biotech-related undergraduate research experiences. Internship mentors were asked to utilize a simple Expectation Clarity Tool to outline the expectations, success metrics, baseline assessments, and training strategy and support that would be foundational to their intern's project. These included expectations around conceptual, technical, performance, and professional skills and behaviors. Concurrently, but independently, community college interns were asked to complete the same type of exercise as a way of identifying gaps in their knowledge and understanding of their mentor's expectations and their internship project. The mentor's completed Expectation Clarity Tool was then shared with their intern. As a result of completing this relatively simple intervention, the majority of mentors reported that it increased their confidence as a mentor, taught them a new mentoring skill, changed how they will mentor trainees moving forward, and positively impacted their relationship with their trainee. On the intern side, the majority of interns reported that engaging in this intervention, both as an independent exercise and in obtaining their mentor's completed Expectation Clarity Tool, increased their confidence as an intern and positively impacted the success of their internship.

‘Just because I have prostate cancer doesn’t mean that I can’t do things’ – men’s experiences of the acceptability of an exercise intervention for prostate cancer during treatment

BackgroundStructured exercise has an important role in mitigating the extensive side effects caused by ongoing prostate cancer treatments, specifically androgen deprivation therapy (ADT) and radiation therapy (RT). Little is known about men’s experiences of, and preferences for, structured exercise programmes during active cancer treatment. This study aimed to inform the acceptability of a 6-month supervised intervention that emphasised increasing and varied intensities of aerobic and resistance exercise, by exploring the experiences of men who participated.MethodsIndividual semi-structured interviews were conducted with an interviewer independent of the exercise study and data was analysed using a descriptive qualitative design.ResultsTwelve prostate cancer patients were interviewed including participants who completed (n = 9) and withdrew from (n = 3) the intervention. Four main themes captured how men experienced the intervention: (1) Navigating the Unknown: Building confidence amidst vulnerability (subtheme- pushing the limits), (2) Building Trust: The credibility and approach of the exercise instructor (subtheme- appropriateness of supervised vs. independent exercise), (3) Flexibility in Delivery, (4) Finding Purpose: Exercise as a means of escapism and regaining control during treatment.ConclusionWhile an initial lack of self-confidence can be a barrier to exercise participation, exercise programmes have the potential to provide psychosocial benefits, rebuild confidence and empower men throughout their cancer treatment and into recovery. Structured exercise is acceptable during treatment including RT and can offer a form of escapism and sense of control for men navigating their cancer journey. Trust building, flexible delivery and credibility alongside a challenging exercise prescription are important facilitators of acceptability for men. Strategies to embed exercise from the point of diagnosis through ADT and RT should reflect men’s experiences of exercise during treatment.Trial registrationThe trial has been registered on ClinicalTrials.gov as of the 14th of December 2021 (NCT05156424).

Intra-Individual Variations in How Insulin Sensitivity Responds to Long-Term Exercise: Predictions by Machine Learning Based on Large-Scale Serum Proteomics.

Physical activity is effective for preventing and treating type 2 diabetes, but some individuals do not achieve metabolic benefits from exercise ("non-responders"). We investigated non-responders in terms of insulin sensitivity changes following a 12-week supervised strength and endurance exercise program. We used a hyperinsulinaemic euglycaemic clamp to measure insulin sensitivity among 26 men aged 40-65, categorizing them into non-responders or responders based on their insulin sensitivity change scores. The exercise regimen included VO2max, muscle strength, whole-body MRI scans, muscle and fat biopsies, and serum samples. mRNA sequencing was performed on biopsies and Olink proteomics on serum samples. Non-responders showed more visceral and intramuscular fat and signs of dyslipidaemia and low-grade inflammation at baseline and did not improve in insulin sensitivity following exercise, although they showed gains in VO2max and muscle strength. Impaired IL6-JAK-STAT3 signalling in non-responders was suggested by serum proteomics analysis, and a baseline serum proteomic machine learning (ML) algorithm predicted insulin sensitivity responses with high accuracy, validated across two independent exercise cohorts. The ML model identified 30 serum proteins that could forecast exercise-induced insulin sensitivity changes.

NSAIDs do not influence exercise effects on muscle size in rats or muscle protein synthesis signaling in humans

BACKGROUND: The aim of this project was to determine the impact of non-steroidal anti-inflammatory drugs (NSAIDs) on skeletal muscle adaptations to exercise. NSAIDs possess analgesic and anti‐inflammatory properties that occur by blocking cyclooxygenase (COX) enzymes, thereby inhibiting the production of prostaglandins. In the first study, we determined if low-dose chronic NSAID use affects muscle size in rodents exercising for six weeks. In the second study, we determined if a single high dose of NSAIDs effects the muscle protein synthetic signaling response to a bout of plyometric exercise. Our hypotheses were that NSAIDs would reduce both muscle size and muscle protein synthesis (MPS) signaling. METHODS: Study 1: 9-wk-old male Wistar rats (n=80) were randomized to placebo (PLA), naproxen (NAP), ibuprofen (IBU), or flurbiprofen (FLU) with or without exercise (EX) for six weeks. Exercise consisted of treadmill running at 25 m/min, for 30 minutes per day, five days per week. Soleus muscle was stained for myosin heavy chain (MHC) I or MHC IIA then analyzed for cross sectional area (CSA) and fiber type percentage. Rodent data were analyzed using a one-way ANOVA. Study 2: In a randomized, counter-balanced order, 12 participants (2 females, 10 males), performed four independent plyometric exercise bouts consisting of 10 sets of 10 plyometric jumps at 40% of their 1RM, separated by a minimum of one week. Prior to each session, participants consumed a single dose of celecoxib (CEL 200 mg), IBU (800 mg), FLU (100 mg) or PLA. Muscle biopsies were collected before (PRE) and 3-hours post (POST) exercise. Muscle was analyzed via immunoblot for the following: phospho(p)-AKT(S473), total AKT, p-mTOR (S448), total mTOR, p-S6 (S235/236), total S6, p-4EBP1, and total 4EBP1. Fold changes were calculated from PRE to POST. Data were analyzed using a repeated measures ANOVA. All data are presented as mean ± SD. RESULTS: Study 1: There was no significant difference (p<0.05) in muscle CSA (PLA: 4060±517; PLA+EX: 3965±605; IBU: 3720±804; IBU+EX:4129±477; FLU: 3743±671; FLU+EX: 3649±541; NAP: 4157±1011; NAP+EX: 4123±586) or MHC IIA percentage (PLA: 10±7; PLA+EX: 10±5; IBU: 7±5; IBU+EX:9±3; FLU: 11±4; FLU+EX: 11±6; NAP: 11±4; NAP+EX: 12±3) between groups. Study 2: There was no significant difference (p<0.05) in fold-change between groups for p-AKT/total AKT (PLA: 1.23±0.4; IBU: 1.13±0.3; CEL: 1.26±0.4; FLU: 1.31±0.4), p-mTOR/total mTOR (PLA: 1.21±0.2; IBU: 1.21±0.3; CEL:1.34±0.2; FLU: 1.49±0.3), p-S6/total S6 (PLA: 11.48±10.6; IBU: 10.9±6.8; CEL: 6.01±2.98; FLU: 25.25±19.38), or p-4EBP1/total 4EBP1 (PLA: 1.71± 1.35; IBU: 1.23±0.98; CEL: 1.07 ±0.64; FLU: 2.03±1.49). CONCLUSION: Chronic low-dose NSAID consumption does not influence muscle size or MHC in exercising rodents. Similarly, an acute high dose of an NSAID does not affect the MPS signaling response in exercising humans. Funding was provided by the Military Operational Medicine Research Program. The opinions or assertions contained herein are the private views of the author(s) and are not to be construed as offcial or as reflecting the views of the Army or the Department of Defense. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

THE EFFECTIVENESS OF PROGRESSIVE RESISTANCE TRAINING IN MANAGING PROGRESSIVE SUPRANUCLEAR PALSY: A CASE STUDY

SETTING The Centre for STRONG Medicine is an outpatient multidisciplinary geriatric service at Concord Hospital, Sydney. An 82-year-old male with a primary diagnosis of Progressive Supranuclear Palsy (PSP) with cardiac and metabolic comorbidities was referred in March 2023. PSP is a rare neurological disorder that affects gait, balance, vision, and cognition. The participant mobilised with a rollator and had previously sustained vertebral and wrist fractures secondary to falls. MANAGEMENT Management was to use progressive resistance training (PRT) to combat mobility decline, prevent falls and provide education to encourage independent exercise. Initial assessment determined current health status using Falls Self Efficacy Scale (FSE-I) and Fried Frailty Phenotype (FFP) questionnaires, and measured function and strength using maximal gait speed, five times sit-to-stand (5xSTS) and one repetition maximum (1RM), respectively. FSE-I determined a high fear of falling and FFP determined frail classification. Outcomes informed the PRT exercise prescription targeting the major muscle groups for 2-3 sets of 7-9 repetitions at 70-85% 1RM progressed gradually and preformed twice weekly in a supervised group. Education regarding breathing, exercise tempo, rest, progression, and risk mitigation were provided. All outcomes were reassessed after 12-weeks of training. RESULTS Attendance was 100% (23 sessions) with improvement in all outcomes. Functional improvements included 0.25metres/second increase in maximal gait speed, 2.5 second reduction in 5xSTS, and safe mobilisation without a rollator. Strength improvements included 101% increase in 1RM leg press, 100% increase in 1RM triceps extension and 72% increase in 1RM seated row. Frailty status improved to pre-frail and fear of falling reduced. Self-reported improvements included increased steadiness and confidence exercising unsupervised. DISCUSSION Although PSP is progressive, PRT resulted in meaningful benefits in strength and function that improved daily task performance and confidence. Further research is needed to investigate the effects of PRT on PSP management in a larger cohort.

Personalised exercise rehabilitation in cancer survivorship: the percs triage and referral system study protocol

BackgroundTo effectively embed exercise rehabilitation in cancer survivorship care, a co-ordinated system of acute and community exercise rehabilitation services, forming a stepped model of care, is recommended. Patients can be directed to the exercise rehabilitation service which best meets their needs through a system of assessment, triage and referral. Triage and referral systems are not yet widely applied in cancer survivorship practice and need to be evaluated in real-world contexts. The PERCS (Personalised Exercise Rehabilitation in Cancer Survivorship) study aims to evaluate the real-world application of an exercise rehabilitation triage and referral system in cancer survivors treated during the COVID-19 pandemic. Secondary aims are to evaluate change in physical and psychosocial outcomes, and to qualitatively evaluate the impact of the system and patient experiences, at three months after application of the triage and referral system.MethodsThis study will assess the implementation of an exercise rehabilitation triage and referral system within the context of a physiotherapy-led cancer rehabilitation clinic for cancer survivors who received cancer treatment during the COVID-19 pandemic. The PERCS triage and referral system supports decision making in exercise rehabilitation referral by recommending one of three pathways: independent exercise; fitness professional referral; or health professional referral. Up to 100 adult cancer survivors treated during the COVID-19 pandemic who have completed treatment and have no signs of active disease will be recruited. We will assess participants’ physical and psychosocial wellbeing and evaluate whether medical clearance for exercise is needed. Participants will then be triaged to a referral pathway and an exercise recommendation will be collaboratively decided. Reassessment will be after 12 weeks. Primary outcomes are implementation-related, guided by the RE-AIM framework. Secondary outcomes include physical function, psychosocial wellbeing and exercise levels. Qualitative analysis of semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR) will provide insights on implementation and system impact.DiscussionThe PERCS study will investigate the real-world application of a cancer rehabilitation triage and referral system. This will provide proof of concept evidence for this triage approach and important insights on the implementation of a triage system in a specialist cancer centre.Trial registrationThis study is registered on ClinicalTrials.gov, registration number: NCT05615285, date registered: 21st October 2022.

'The illness isn't the end of the road'-Patient perspectives on the initiation of and early participation in a multi-disease, community-based exercise programme.

Exercise is the cornerstone of cardiac rehabilitation (CR). Hospital-based CR exercise programmes are a routine part of clinical care and are typically 6-12 weeks in duration. Following completion, physical activity levels of patients decline. Multi-disease, community-based exercise programmes (MCEP) are an efficient model that could play an important role in the long-term maintenance of positive health behaviours in individuals with cardiovascular disease (CVD) following their medically supervised programme. To explore patients experiences of the initiation and early participation in a MCEP programme and the dimensions that facilitate and hinder physical activity engagement. Individuals with established CVD who had completed hospital-based CR were referred to a MCEP. The programme consisted of twice weekly group exercise classes supervised by clinical exercise professionals. Those that completed (n = 31) an initial 10 weeks of the programme were invited to attend a focus group to discuss their experience. Focus groups were transcribed and analysed using reflexive thematic analysis. Twenty-four (63% male, 65.5±6.12yrs) patients attended one of four focus groups. The main themes identified were 'Moving from fear to confidence', 'Drivers of engagement,' and 'Challenges to keeping it (exercise) up'. Participation in a MCEP by individuals with CVD could be viewed as a double-edged sword. Whilst the programme clearly provided an important transition from the clinical to the community setting, there were signs it may breed dependency and not effectively promote independent exercise. Another novel finding was the use of social comparison that provided favourable valuations of performance and increased exercise confidence.

RESULTS OF PROGRAM IMPLEMENTATION THE INDEPENDENT WILL BE BUSY WITH PHYSICA EXERCISES IN STRESSFUL SITUATIONS AMONG YOUTH STUDENTS

The article examines the effectiveness of the program of independent physical exercises in stressful situations among students of the Dnipro National University named after Oles Gonchar.
 War is seen as a source of extreme stress that is unexpected and extremely intense. Its psycho-traumatic potential is connected with this. Therefore, it is important to understand what means can be used to bring a person out of a stressful state and to treat mild forms of mental disorders caused by stress. It is especially relevant to consider those methods of combating stress that do not require any additional costs, and therefore are generally available to everyone.
 A program of independent classes was developed according to scientific studies, which claim that anaerobic activity is as effective in stressful conditions as aerobic exercises, regime of alternating strength exercises and aerobics with a duration of 30 minutes. Exercise intensity was moderate to moderate, as any positive effect of exercise on reducing the risk of depressive symptoms may be limited by exercise intensity.
 Results received. The number of respondents who had a moderate degree of depression according to the Beck scale decreased by 15%. Also, the number of students with a mild degree of depression decreased by 34%, and the number of students with a normal psychological state increased accordingly (by 49%). Conclusions were made: 1. Self-exercise is an opportunity to support both physical and psychological health of a person. 2. In a stressful state, motor activity is a mandatory component for getting out of it and reducing its effect. 3. To reduce symptoms of depression, the focus should be on exercise frequency, not duration or intensity. 4. A mandatory condition for teachers of physical education departments of higher education institutions is the education of priority health orientations in students, motivational incentives for regular independent physical exercises, because systematic training is an important guarantee of normal physical and spiritual development of young people.

Physiotherapy Management of Total Knee Replacement Et Causa Osteoarthritis Genu with Transcutaneous Electrical Nerve Stimulation Modalities and Exercise Therapy in Banten Provincial Hospital

Osteoarthritis is a chronic disease that most often occurs in elderly people aged over65 years. The age-standardized incidence of knee OA is 3.8% worldwide and 80% ofpatients over 75 years of age have radiologically proven OA. Knee osteoarthritissufferers usually complain of pain, swelling, limited joint mobility, and stiffness due toinflammation of the synovial joints. OA of the knee can also cause disruption offunctional activity and interference with patient work (Thacoor & Sandiford, 2019).This research aims to find out more about the benefits of using TENS in reducing painand the benefits of exercise therapy in increasing the range of motion of joints andincreasing lower leg muscle strength as a result of total knee replacement. This type ofresearch is descriptive and action research with the subject Ny. I with medical recordsPost total knee replacement dextra surgery. Results of the physiotherapy managementprocess for Total knee replacement et causa osteroarthritis knee dextra withTranscutaneus Nerve Stimulation and exercise therapy in Ny. 1, aged 53 years, came tothe Banten Provincial Regional Hospital in November with the problem of pain in theright knee, limited range of motion of the joint, decreased muscle strength, anddecreased functional activities such as squatting and going up and down stairs. Afterundergoing physiotherapy six times from November 16, 2022 to December 19, 2022using Transcutaneal Electrical Nerve Stimulation (TENS) and Exercise Therapy, theresults showed that the level of pain had decreased, the range of motion of the jointshad increased, muscle strength had increased, and the patient's functional activity hadimproved. has increased, although not completely. It is hoped that education andhome programs, independent exercises given by therapists to patients must always beimplemented with family support to get maximum results and remind patients aboutwhat is recommended by the physiotherapist for the patient's recovery and recovery.

Independent Exercise During a Videoconference Exercise Program for Cancer Survivors

ABSTRACT Background Independent exercise beyond supervised sessions can help program participants achieve recommended exercise levels and contribute to health benefits. However, independent exercise is rarely reported, making it unclear how much program effects may be attributed to the supervised sessions. The aim of this study was to describe independent exercise during a videoconference-delivered exercise program for cancer survivors. Methods Cancer survivors (N = 46) completed an 8-week program that included videoconference-delivered (i.e., Zoom) exercise sessions once per week and three behavior change discussions. Each week, participants reported frequency, duration, intensity, type, and context (e.g., where, type, with whom) of independent aerobic and resistance exercise. Results Participants (mean ± SD age = 59 ± 10 years; 96% female) had been diagnosed with either ovarian (61%), breast (30%), colorectal (4%), or other (4%) types of cancer. Days per week of independent exercise were 2.7 ± 2.7 for light, 2.8 ± 2.2 for moderate, and 0.67 ± 1.3 for vigorous aerobic exercise. For resistance exercise the days per week performed was 1.3 ± 1.5. Median weekly independent minutes were 60 (range: 0–120) for light aerobic, 120 (range: 36–270) for moderate-to-vigorous aerobic, and 30 (range: 0–60) for resistance exercise. Independent exercise performed was most frequently brisk walking or weightlifting at home or in the neighborhood and with a spouse/partner, other family, or friends. Conclusion Most participants engaged in substantial independent exercise outside of the supervised sessions. These findings provide detailed contextual information regarding independent exercise during an 8-week program and have implications for interpreting program effectiveness.

Virtual Physical Prehabilitation in Lung Transplant Candidates: A Proof-of-Concept Study.

This study aimed to preliminary test the effectiveness of 12-week virtual physical prehabilitation program followed by a maintenance phase. The main objective was to estimate the extent to which it affects exercise capacity, frailty, lower limb strength and health-related quality of life (HRQOL) in lung transplant candidates. The program offered supervised strengthening exercises, independent aerobic exercises and weekly phone calls (maintenance phase). Primary outcome was the six-minute walk distance (6MWD). Secondary outcomes: the Short Physical Performance Battery (SPPB), five-times sit-to-stand test (5STS), the St George's Respiratory Questionnaire (SGRQ) for HRQOL. Twenty patients were included (mean age 57.9; 6 women/14 men); fourteen completed the prehabilitation program and 5 completed the maintenance phase. There was no statistically significant improvement in 6MWD, SPPB or SGRQ after the 12-week program. Most patients either maintained or improved the 6MWT and SPPB scores. There was a significant improvement in the 5STS. After the maintenance phase, most patients either improved or maintained their scores in all outcomes except for the sub-score of symptoms in the SGRQ. A 12-week virtual physical prehabilitation program with a 12-week maintenance phase can help lung transplant candidates improve or maintain their physical function while waiting for transplantation.

Effects of Phase Ⅰ Cardiac Rehabilitation Combined with Cognitive Behavioural Therapy on Cardiac Function, Exercise Capacity and Mental Health in Patients after Aortic Valve Replacement: A Retrospective Study.

To explore the application effect of phase Ⅰ cardiac rehabilitation (CR-Ⅰ) combined with cognitive behavioural therapy (CBT) on patients after aortic valve replacement (AVR). This study retrospectively analysed the data of 441 patients after AVR in our hospital from January 2020 to May 2023. A total of 38 patients who did not meet the inclusion criteria were excluded. A total of 403 patients were included. In accordance with different postoperative management schemes, the included patients were divided into the reference group (n = 202, received CR-Ⅰ) and the observation group (n = 201, received CR-Ⅰ+CBT). The cardiac function, exercise capacity and mental health of the two groups were compared. Before management, both groups had no significant differences in left ventricular end diastolic diameter (LVEDD), left ventricular end systolic dimension (LVESD), left ventricular ejection fraction (LVEF) and six-minute walking test (6MWT) scores (p > 0.05). At discharge and 3 months after discharge, the observation group had significantly lower LVEDD and LVESD and remarkably higher LVEF and 6MWT scores than the reference group (p < 0.001). The proportions of autonomous activity in bed within 3-4 days after surgery, autonomous out-of-bed activity within 8-10 days after surgery and autonomous walking 200 m within 12-15 days after surgery were distinctly higher (p < 0.001) and the incidence of adverse reactions was overtly lower (p < 0.001) in the observation group than in the reference group. Before management, both groups had no significant difference in their scores on the State-Trait Anxiety Inventory (STAI) (p > 0.05). At discharge and 3 months after discharge, the observation group had lower STAI scores than the reference group (p < 0.001). CR-Ⅰ combined with CBT effectively improves the cardiac function, independent exercise capacity and mental health level of patients after AVR and provides a new direction for the formulation and selection of follow-up clinical management.

Experiences of physiotherapists considering virtual reality for shoulder rehabilitation: A focus group study.

Shoulder pain is common and associated with substantial morbidity. Different treatment strategies are being prescribed with equivocal results. Virtual reality (VR) is a novel technology and emerging research suggests that VR may be a promising alternative to current treatments. Prior to effectiveness research or any large-scale introduction, VR-applications require appropriate scrutiny including feasibility- and acceptability of clinicians and patients. Therefore, the aim of this study was to collect experiences of physiotherapists after using immersive VR. A qualitative interpretive design was used to explore physiotherapists' experiences related to the use of VR for people with shoulder symptoms. 17 physiotherapists were asked to use VR at home for five days prior to a focus group interview. Data from the focus group interviews were analyzed using a six-phase process of thematic analysis. Three main themes were identified, each divided into subthemes. The main themes were: 1. VR as an extension of contemporary physiotherapy care: physiotherapists were positive about the potential of VR and its applicability in daily care. 2. Physiotherapist uncertainties of future care using VR: participants expressed concerns about their professional identity, particularly as patients engage in independent home exercises. 3. Physiotherapist's requirements for implementation of VR: participants shared their needs for evidence regarding the effectiveness and parameters such as frequency, dosage and intensity of the VR intervention. Physiotherapists were positive about VR as an intervention tool. However, they felt more knowledge is needed about parameters of VR. The findings of this study inform researchers and technology developers about optimal design of interventions and applications using VR.

Edukasi Lansia Sehat Bebas Osteoarthritis Lutut di Posyandu Teratai Keprabon

The elderly are an age where degenerative diseases often occur, one of the diseases suffered by the elderly is knee osteoarthritis. Knee osteoarthritis (OA) is a degenerative and progressive disease that attacks the knee joints resulting in functional limitations in the elderly. Knee osteoarthritis is caused by an unhealthy lifestyle, lack of exercise, and body weight which are risk factors for knee osteoarthritis. At the posyandu Teratai Keprabon, many elderly people complained of knee pain. This activity is an outreach regarding osteoarthritis and education regarding independent exercise to strengthen and reduce pain in the knee. This activity takes the form of providing leaflets, pre-test, post-test to measure the level of knowledge of the elderly regarding osteoarthritis. Based on the results of filling out the questionnaire, it was seen that the elderly had an increased understanding of osteoarthritis, such as signs and symptoms as well as exercises to reduce pain and strengthen muscles in the knee.

Depressive symptoms associated with infection prevention measures and daily lifestyle habit characteristics among Japanese community-dwelling older adults during the COVID-19 pandemic.

This study aimed to clarify the relationship between depressive symptoms and infection prevention measures and daily lifestyle habits during the coronavirus disease 2019 pandemic among community-dwelling Japanese older adults. This cross-sectional study was conducted on older residents (age ≥65 years) living in the Tama area of Tokyo and Sapporo, Hokkaido, in 2021. A self-administered questionnaire survey was conducted to collect data on demographics, the impact of the pandemic on physical condition, and depressive symptoms, infection prevention measures, and daily lifestyle habits during the pandemic. The Geriatric Depression Scale was used to assess depressive symptoms. In total, 554 respondents were included in the analysis. The results of multiple logistic regression analyses revealed that refraining from going out and visiting medical institutions were associated with depressive symptoms. Furthermore, those who went out almost every day were less likely to have depressive symptoms than the others, those who exercised almost every day were less likely to have depressive symptoms than were those who almost never exercised, and those who slept 6-7 h were less likely to have depressive symptoms than were those who slept ≤5 h. The findings of the present study suggest the necessity of having a place where older adults with physical and lifestyle concerns can consult with healthcare providers in a location other than a medical institution, even during infectious disease outbreaks. In addition, increasing the frequencies of going out and independent exercise and sleeping 6-7 h may help prevent depression among older adults.

Reported Experience of Women Who Received a New Self-management Physical Therapy Instruction before Breast Cancer Surgery - A Case Series

Objective: The need to provide information and instruction for patients post breast cancer (BC) surgery is highly supported. Several studies have shown pre-surgery instruction to be beneficial. However, as information about the experience of patients receiving pre-surgery instruction is limited, this case series aims to describe the experience of nine individual women who received newly developed, updated, self-management physical therapy (PT) instruction before BC surgery. Methods: Participant interviews were conducted by telephone using a list of questions prepared in advance about their personal experience. Medical files provided demographic and medical data. Interviews were performed by one physical therapist, transcribed, and analysed by two co-authors. Similarities and differences between transcripts were summarized. Results: Most participants found the instruction content to be easily understood and beneficial. They also expressed the value of receiving instruction before BC surgery. Nine felt that the instruction should be routinely provided. Criticism was mainly for lack of instruction regarding pain control, dealing with exercise fear avoidance, and that women unfamiliar with self-management and independent exercise may benefit less. Conclusion: Most participants found the new instruction understandable and beneficial when provided pre-surgery. However, this may not be suitable practice for all women as some may need personalized post-surgery instruction. Therefore, in addition to pre-surgical instruction provision, a post BC surgery PT visit would identify those requiring individualized instruction. Information about outpatient PT services should be added to pre-surgery instruction. Future studies should examine content and provision timing in a large sample of participants.