Exercise Plan Research Articles

Telerehabilitation following fast-track total knee arthroplasty is effective and safe: a randomized controlled trial with the ReHub® platform

Purpose After a total knee arthroplasty (TKA), ensuring rehabilitation is continued at home is essential for a successful recovery. The aim of this randomized clinical trial (NCT04155957) was to demonstrate the safety and efficacy of an interactive telerehabilitation system (ReHub®) to guide and provide feedback during exercise in the postoperative period of a fast-track TKA program. Methods Fifty-two patients who underwent TKA were randomized to intervention (N = 26) or control (N = 26). Upon discharge, they followed a 4-week plan of 5 daily exercises and up to 10 physiotherapy home visits. The intervention group performed exercises with ReHub® autonomously, control did not use any auxiliary device. Data were collected 1) on the day of discharge, 2) after 2 weeks and 3) after 4 weeks. Results Telerehabilitation patients showed higher adherence to exercise (p = 0.002) and greater quadriceps strength (p = 0.028). No significant differences between groups were found in other outcomes. Only 1 adverse event was linked to ReHub®. Patients gave the platform high System Usability Scale scores (83/100). Conclusion Interactive telerehabilitation with ReHub® during a post-TKA exercise program is effective, safe, and well-received by patients. It provides real-time performance feedback and ensures communication. Quadriceps strength and adherence to the exercise plan are improved with ReHub®.

Impact of a 7-day retreat for people with Parkinson's disease: a phenomenological study.

Aim: Early and ongoing access to rehabilitation and exercise may preserve functional mobility and quality of life for persons with Parkinson disease (PwP). The aim of the current study was to describe the experience of PwP who participated in a 7-day retreat. Materials & methods: A phenomenological approach was used to describe the lived experience of PwP. Results: Three themes emerged from interviews: a community of shared information where participants discussed exercising and learning with other PwP; improved control of Parkinson's disease symptoms, including performing physical tasks more easilyand renewed motivation for their long-term plans for exercise because of the retreat. Conclusion: A 7-day retreat for PwP positively impacted perceived control of disease-related symptoms and intentions to continue exercise.

Effectiveness of Using Exercise App in Improving Exercise Adherence and Aerobic Endurance of Football Players

Introduction. The use of mobile apps known as mHealth is starting to shape the delivery of physical therapy care not only in patients but also to the healthy population. Using an exercise app is a potential strategy to promote physical activity among individuals. Thus, this pilot study examined the utility of the Nike® Training Club app in increasing exercise adherence and enhancing aerobic endurance. Methods. The study utilized one-way repeated measures over time quasi-experimental design. It used purposive sampling to select 10 college football players aged 18-25 years old. After downloading the app, the participants were required to perform a workout plan composed of 15–45 minutes workouts through circuit interval training. The 20-day workout plan was done for 6 weeks (3-4 workouts per week). Aerobic endurance was measured at baseline and every after 2 weeks of intervention using Cooper’s 12-minute run test. Results. An extremely high adherence rate (85%, SD = 2.11) to exercise was exhibited by the participants based on recorded logs in the app. Also, the participants agreed that the app was easy to use (x̅ = 3.9, SD = .18) due to its user-friendly interface, uncomplicated design, and comprehensive features. Results also showed an improvement in their aerobic endurance at the end of the 6-week training with a change of 3.8 ml/kg/min, however, ANOVA showed no statistically significant difference in VO2 max from baseline to post-tests [F (3, 10) = 2.18, p = .11]. Discussion. A high adherence to exercise may be achieved when exercise is facilitated using the app. The app has potential to provide information that could lead to improvements in aerobic endurance and can be a useful tool in maintaining an active lifestyle among the well population.

Experience of patients and physiotherapists within the AFTER pilot randomised trial of two rehabilitation interventions for people aged 50 years and over post ankle fracture: a qualitative study

ObjectivesTo explore patient and staff experience of best-practice rehabilitation advice (one session of face-to-face self-management advice with up to two additional optional sessions) compared with progressive functional exercise (up to...

The Concept of Ta'dib According to An-Naquib Al-Attas And Humanism According to Paulo Freire and their Relevance with Islamic Education

A Naquib Al-Attas, with the idea of ta' dib, talks about to plan exercises to strengthen oneself in examining this open world. A Naquib Al- Attas is one of the figures who have impressive thoughts and figures in the improvement of contemporary Islamic training thought. Paulo Freire, with the concept of humanism, is interested in achieving the primary goal of education that humanizes humanity so that the potential within the subject of education can be developed. This study aims to describe and find essential points of thought of the concept of education, according to An-Naquib Al-Attas and Paulo Freire, and explain the relevance of the two figures' educational concepts with Islamic education. This research is qualitative. Furthermore, the type of research the writer chooses is library research with descriptive analysis. The primary data sources in this study are An-Naquib Al-Attas and Paulo Freire books that have been translated into Indonesian. Secondary data sources are taken from books relevant to the two educational concepts. Techniques of collecting data using techniques Implementing data that is analyzed with content. This exploration yielded results on the idea of ta' dib A Naquib Al-Attas and Paulo Freire's humanism that are applicable to Islamic instruction, while Freire's innovativeness despite everything bolsters the solid with common and training in Indonesia. No. 20 of 2003 can be affirmed.

Superfoods for Type 2 Diabetes: A Narrative Review and Proposal for New International Recommendations.

Background and Objectives: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease affecting an estimated 537 million individuals worldwide. 'Superfoods' can be integrated into the diet of T2DM patients due to their health benefits. Study Objectives: (i) To carry out a narrative review of 'superfoods' with the potential to reduce glycaemic levels in T2DM patients (2019 to 2022), (ii) to identify 'superfoods' with the potential to reduce HbA1c and (iii) to propose new guidance on the use of 'superfoods'. Materials and Methods: A narrative review was carried out using the databases PubMed, SciELO, DOAJ and Google Scholar. The keywords were ["type 2 diabetes" and ("food" or "diet" or "nutrition") and ("glycaemia" or "glycemia")]. Only review studies were included. Results: Thirty reviews were selected. The 'superfoods' identified as having a potential impact on glycaemic control were foods with polyphenols (e.g., berries), fermented dairy products, whole cereals/grains, nuts and proteins, among others. The possibility of an extensive reduction in Hb1Ac was reported for fermented dairy products, especially yoghurts enriched with vitamin D or probiotics (HbA1c reduction of around 1%) or by increasing the fibre intake by 15 g (or up to 35 g) (HbA1c reduction of around 2%). Conclusion: It is recommended that the identified 'superfoods' are included in the diet of T2DM patients, although this should not substitute an appropriate diet and exercise plan. In particular, yoghurts and an increased fibre intake (by 15 g or up to 35 g) can be used as nutraceuticals. New recommendations on the introduction of 'superfoods' in the diet of T2DM patients have been proposed.

Can We Improve Clinical Outcomes and Patient Engagement after TKA Using a Digital Health Remote Monitoring Platform? Perioperative Results with Recupe

Background: In their recovery plan, total knee arthroplasty (TKA) patients generally receive outpatient physical therapy and a home exercise plan. However, in the past home exercise plan compliance was not able to be tracked. With the advent of digital health, such as Plethy’s Recupe mobile app, home exercise plans can now be measured, providing compliance data along with exercise specific data.
 Methods: Out of 245 TKA patients on Recupe, 53 patients were selected who performed exercises both pre-op and post-op, and also stayed on their program for at least 40 days and had a minimum of 50% engagement.
 Results: Pain decreased significantly from pre-op (3.6/10) and 1st week (4.28/10) post op to 1 month post-op (2.65/10). Knee Flexion ROM increased significantly from the 1st week post op (44.72) to 1 month Post op (58.13). This was the range of motion performed during home exercises, not the max measurement from a healthcare provider.
 Patients engaged the app 5.6 times per week. Previous research showed non-compliance at up to 70%.
 Conclusions: This study suggests that digital health can help keep patients engaged in their home exercises. Those who adopt it show excellent engagement. This will likely lead to improved pain and ROM compared to those without digital health, who are not likely to comply with their prescribed home exercise plan.

Diet and exercise are a fundamental part of comprehensive care for type 2 diabetes.

Diet and exercise are a fundamental part of comprehensive care for type 2 diabetes.

Differential effects of a 12-week aerobic exercise program on health-related physical fitness, physiological and biochemical markers among obese adults: a randomized controlled trial.

Background: work out is an valuable approach for improving standard of living physiological, biochemical, and physical strength in obese patients; though, few researches have mainly focal point on early survival rates, minorities, in physically passive men, and overweight men, or examined individual & combined workout plan and measured body composition markers.
 Objective: In this research we have describes the effect of a 12-week different aerobic exercise involvement on obese people's self-reported result, physical strength, physiological and biochemical markers in ethnically mixed, physically motionless, obese adults.
 Methods: Total (n = 60) male adults with obese (Mean ± SD; age: 18.92 ± 1.54 yrs.; height: 172.4 ± 5.4 cm.; weight: 84.4 ± 6.3 kg) were randomly allocated into three equal (n = 20) groups: Step Aerobic Exercise Training (SAET), Floor Aerobic Exercise Training (FAET) or a control group. The SAET & FAET training protocol has been performed three days of a week during period of study (12 weeks). All the selected variables of physical fitness, physiological and biochemical markers have been examined at baseline and 12 weeks. Group under control have been found not performing workout.
 Results: The exercise program SAET & FAET significantly improved in muscular strength, cardiovascular endurance, flexibility, muscular endurance, vital capacity, and breath holding time (p < 0.05). The workout schedule reduced significantly % body fat, mean resting pulse rate, respiratory rate and arterial blood pressure, (p < 0.05). Furthermore, the lipids levels of total triglycerides, cholesterol, and low density lipoprotein have been reduced significantly in SAET & FAET, high density lipoprotein enhance significantly (p < 0.05).
 Conclusion: Research’s finding advocate that 12-weeks regular SAET & FAET protocols have greater effects than control group on physical fitness of health related, physiological and biochemical variables in obese male adult individuals.

A Continuous Aerobic Resistance Exercise Protocol for Concussion Rehabilitation Delivered Remotely via a Mobile App: Feasibility Study.

In recent years, several studies have consistently reported the beneficial effects of aerobic exercise in alleviating symptoms following concussion. However, exercise modality recommendations by practitioners are often limited to traditional exercise equipment (eg, treadmills and stationary bikes). Advances in digital technologies may help to overcome this limitation, as mobile apps can now provide users with high-quality instructional videos, programs, and monitoring capabilities using alternative modalities such as resistance exercises. Mobile technologies are also rapidly expanding to deliver and complement in-person clinical care. Thus, it is imperative to evaluate this emerging technology on its feasibility, safety, and clinical utility for concussion care. The objective of the study was to determine the feasibility of a mobile app to deliver a resistance exercise protocol with minimal equipment to individuals following concussion. Feasibility was defined by retention, adverse events, and achievement of a target heart rate (HR) of 60%±5% (age-adjusted percentage of max: 220 - age). HR data were collected using an Apple Watch, Series 6. Symptoms were evaluated before and after 3 exercise sessions. A 2-week, prospective, single-arm pilot study was conducted on 21 adults diagnosed with a concussion. Users were provided a continuous aerobic resistance exercise (CARE) protocol through a mobile app. A total of 18 participants (14 female and 4 male) completed a 3-session exercise plan. The median age-adjusted percent of HR max for session 1 was 55.5% (IQR 49%-63%), 58.1% (IQR 50.8%-65.2%) for session 2, and 57.4% (IQR 49.5%-64.7%) for session 3. Individual median HR% across all sessions ranged from 46.9% to 67.4%; furthermore, 10 participants (55.5%) had a total mean HR% within the target HR%, 7 participants had a mean HR% below 55%, and 1 participant had a mean HR% above 65%. In addition, adherence to the plan resulted in a decrease in reported symptom burden with 94% posterior probability. Following concussion, a CARE protocol delivered through a mobile app resulted in no adverse effects with 14% (n=3/21) attrition over 3 sessions. CARE was successful in achieving an aerobic exercise intensity of 55%-65% of age-adjusted maximum HR in the majority of participants and resulted in a decrease in reported symptom burden. The potential for this platform in concussion rehabilitation warrants further investigation. Future studies are needed to assess the use of this technology throughout concussion recovery in both individuals with acute concussion, and those with persistent symptoms.

EXPLORING THE USE OF GNSS DATA IN THE IDENTIFICATION OF ACTIVITY AREAS FOR CENSUS ENUMERATION EXERCISE

The Global Navigational satellite System (GNSS) is a satellite based positioning tool that uses signals from artificial satellites in the space to determine time, velocity and positions. The GNSS receiver has countless uses and these may include navigation, surveying and Mapping in general. The aim of this study is to determine, using the GNSS, areas with dense population and more so, areas of much activities for census planning exercise. The Hi-Target V30 GNSS receiver and its accessories were used for the study. The Hi-Target V30 Standalone Receiver’s Data were collected for 12 months interval observation. Observations were carried out for 1 hour each on ten (10) different stations and the GNSS raw data were downloaded and converted into RINEX data. A Post-Processing platform was used to process the result in ITRF 14 and WGS 84 datum. The differencing of results showed shifts in the directions to much denser populations areas. These shifts, after interpretations could assist enumerators in further decision making. It is obvious that, the GNSS potentials are limitless as the aim of the research was achieved.

Position Statement: Exercise Guidelines for Osteoporosis Management and Fall Prevention in Osteoporosis Patients.

The effectiveness of exercise for improving osteoporosis and fall prevention in patients diagnosed with osteoporosis or osteopenia has not been fully summarized. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology has developed exercise guidelines for patients with osteoporosis or osteopenia and provide evidence-based recommendations. A systematic review identified randomized controlled trials (RCT) assessing the effect of resistance, impact, balance, aerobic training, and physical activity in osteoporosis and osteopenia on bone quality, physical performance, quality of life, and fall prevention. PubMed, Embase, KoreaMed, and RISS were searched from January 2000 to August 2022. Ten key questions were established to review the evidence and formulate recommendations. The 50 RCTs reported that even with osteoporosis and osteopenia, resistance and impact training consistently maximized bone strength, improved body strength and balance, and eventually reduced fall incidences. Resistance exercise combining 3 to 10 types of free weight and mechanical exercise of major muscle groups performed with an intensity of 50% to 85% 1-repetition maximum, 5 to 12 repetitions/set, 2 to 3 days/week, for 3 to 12 months is recommended. Impact exercises such as jumping chin-ups with drop landings and jump rope performed 50 jumps/session for at least 6 months with 3 or more days/week are recommended. A multi-component exercise mainly comprised of resistance and impact exercise seems to be an effective strategy to attenuate the risk factors of osteoporosis and osteopenia. The integration of exercise guidelines and individualized exercise plans has significant potential to reduce the morbidity and mortality of osteoporosis.

A primary care delivered, technology supported lifestyle program for Type 2 Diabetes Management: An evaluation of changes in metabolic health, feasibility, and acceptability – A pilot interventional study protocol

BackgroundType 2 Diabetes (T2D) is associated with significant health complications and socioeconomic costs. Previous research conducted through an outpatient research facility demonstrated use of a low carbohydrate (LC) diet and exercise plan delivered in the format of an education book combined with use of real-time continuous glucose monitoring (RT-CGM) is an effective self-management intervention to improve weight and blood glucose management in patients with T2D. Primary health care remains the central access point for patient management of T2D, but General Practitioners (GPs) lack access to effective evidenced-based, self-management programs that can be prescribed to improve patient outcomes. MethodsA single-arm, within-participant pilot intervention study will be conducted to evaluate the changes in metabolic health, acceptability and feasibility of a prescriptive LC diet and lifestyle program combined with RT-CGM (LC-RTC) delivered via GP practices. Forty adults with T2D will be recruited from GP practices and prescribed the LC-RTC intervention for 12 weeks. Outcomes will be assessed at baseline and 12-weeks post intervention. Changes in metabolic health will be assessed by changes in glycosylated hemoglobin (primary outcome), body weight, blood pressure, blood lipids, and medication usage. Post-intervention, participants will complete questionnaires and participate in focus groups to explore their experience of the LC-RTC program including acceptance, perceived benefits/barriers, limitations, financial feasibility, intervention drop-out rates, participant and GP engagement with the program (clinic attendance and contacts made to clinic for program support) and RT-CGM use and wear time acceptance. GPs and clinical staff involved will participate focus groups to evaluate the perceived value and feasibility of the LC-RTC program. DiscussionThis trial will provide a powered evaluation of the changes in metabolic health, acceptability, and feasibility of the LC-RTC program for patients with T2D delivered via GP practices. Trial registrationANZCTR: 12622000635763 (Website Link to full registration: ANZCTR - Registration). Registered 29th April 2022. Overall trial status: Commenced; Recruitment Status: Commenced 1st May 2022, with 40 participants recruited as of 2nd May 2023 using a rolling recruitment approach.

Adopting Resilience Thinking through Nature-Based Solutions within Urban Planning: A Case Study in the City of València

The paper exposes the experience of València in applying climate-resilient thinking to the current revision of the city’s General Urban Development Plan. A semi-quantitative, indicator-based risk assessment of heat stress was carried out on the 23 functional areas of the city sectorized by the Plan, including modeling and spatial analysis exercises. A data model of 18 indicators was built to characterize vulnerability. A thermal stress map was developed using the URbCLim model and a heat index was then calculated using Copernicus hourly data (air temperature, humidity, and wind speed) for the period of January 2008–December 2017 at a spatial resolution of 100 m × 100 m. General recommendations at the city level as well as guidelines for development planning in the functional areas at risk are provided, with specifications for the deployment of nature-based solutions as adaptation measures. From a planning perspective, the study positively informs the General Urban Development Plan, the City Green and Biodiversity Plan, and contributes to City Urban Strategy 2030 and City Missions 2030 for climate adaptation and neutrality. Applying the same approach to other climate change-related hazards (i.e., water scarcity, pluvial flooding, sea level rise) will allow better informed decisions towards resilient urban planning.

DEALING WITH INSULIN RESISTANCE AMONG WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

One of the most prevalent endocrine disorders in females, polycystic ovarian syndrome (PCOS), affects about 7-8% of women of reproductive age. Most females with PCOS also have increased cholesterol levels, insulin resistance, and BMI, leading to obesity. The study aimed to determine the effects of metformin and lifestyle modification (diet & exercise) on insulin resistance secondary to PCOS after 6 months of use. This RCT study was conducted at Arif Memorial Teaching Hospital from October 2022 to March 2023. The study compared the effects of metformin and lifestyle management, including only a diet plan with the use of metformin diet and exercise plan, on insulin resistance in 130 obese females aged between 20-40 years suffering from PCOS and had insulin resistance as diagnosed by HBA1C blood test. The main outcome measure was the reduction in the HBA1C level. The 130 participants were equally divided into two groups. Group A received metformin only, while Group B received metformin and an exercise plan. Baseline treatment included guidance to adopt a healthy diet. The results showed significant improvement in HBA1C level (P=0.00), BMI (P=0.02), and pregnancy rate. There was an overall improvement in the menstrual pattern but a significant improvement in Group B (P=0.00) than Group A (P=0.06). With a significant rise in follicle-stimulating hormone (FSH) levels in both groups [P=0.06 (A), P=0.01(B)], a statistically significant decrease in luteinizing hormone (LH) [P=0.02 (A), P=0.01(B)] was seen. A total drop in free testosterone level was also seen, but it wasn't significant [P=0.08 (A), P=0.06 (B)]. The study concluded that insulin resistance could be controlled effectively by acquiring a healthy lifestyle, including high protein and low carb, caloric deficient diet, and following an exercise plan and pharmacological treatment. Combining all three treatment options is more effective than using any one option as treatment.

Postural assessment with the moiré technique in dialyzed patients.

Chronic kidney disease (CKD) patients have limited mobility. A disease that lasts for many years may harm the musculoskeletal system. Knowledge about changes in body posture in these patients is essential in preventing its degradation. In this work, we wanted to draw attention to the changes in the spatial arrangement of the spine and the entire torso in dialysis patients. The study group consisted of 22 female and 32 male dialysis patients. The posture was examined using the moiré projection technique with a portable Computer-Aided System for Posture Assessment which calculated 82 angular and linear parameters of the spine, scapulae, and pelvis in the frontal and sagittal planes. A significant sexual dimorphism was observed for each spine segment. Asymmetry of the scapulae and pelvis was observed in both sexes. Abnormalities may help to establish an accurate exercise plan for dialysis patients. Proper stimulation of the locomotor system can prevent further degradation of body posture.

An International Survey of Peritoneal Dialysis Exercise Practices and Perceptions

Low activity levels and poor physical function are associated with technique failure and mortality in people receiving peritoneal dialysis (PD). Adequate levels of physical function are required to maintain independence for people choosing this predominantly home-based therapy. The objective of this study was to identify the exercise-related perceptions and practices of PD clinicians globally. We conducted a cross-sectional survey of PD clinicians from English-, Thai-, Spanish-, and Portuguese-speaking PD-prevalent countries exploring clinicians' perceptions and practices of swimming, activity following PD catheter insertion, lifting, and falls prevention. This study was convened by the International Society of Peritoneal Dialysis and Global Renal Exercise Network between July and December2021. Of 100 of the highest PD-prevalent countries, 85 responded and were represented in the findings. A total of 1125 PD clinicians (448 nephrologists, 558 nephrology nurses, 59 dietitians, and 56 others) responded from 61% high-income, 32% upper middle-income and 7% lower middle-income countries. The majority (n= 1054, 94%) agreed that structured exercise programs would be beneficial for people receiving PD. Most respondents believed people on PD could perform more exercise (n= 907, 81%) and that abdominal strengthening exercises could be safely performed (n= 661, 59%). Compared to clinicians in high-income countries, clinicians from lower middle-income status (odds ratio [OR], 5.57; 1.64 to 18.9) are more likely to promote participation in physical activity. Clinicians know the importance of physical activity in people receiving PD. Exercise counseling and structured exercise plans could be included in the standard care of people receiving PD to maintain independence.

Crisis Collaboration Exercises: Are They Useful?

Introduction:Crisis collaboration exercises are perceived as developing and testing cross-sectoral team integration, preparedness efforts, and response. However, the general problem is that crisis collaboration exercises may tend to produce results with limited usefulness in actual crisis work. The purpose of this quantitative, non-experimental, survey-based study was to examine to what extent there was a statistically significant relationship between participation in Norwegian maritime crisis collaboration exercises and the perceived levels of learning and usefulness in an actual crisis. The scope was limited to relevant public, military, and non-governmental exercise participants.Method:Surveys were electronically distributed among participants in three 2016 Norwegian maritime crisis collaboration exercises. The data collection instrument was the Collaboration, Learning, and Utility scale (Berlin & Carlström, 2015). The CLU-Scale is specially designed to measure collaboration exercise participants' perceived levels of learning and utility. The scope was limited to relevant public and non-governmental exercise participants including health, law enforcement, and military stakeholders.The effects of collaboration, learning, and usefulness were tested in two bivariate regression analyses, where the first tested the relationship between collaboration and learning, and the second tested the relationship between learning and usefulness. To measure the linear dependence between the variables, Pearson’s r was calculated. The coefficients of determination (r2) were calculated to determine what proportions of the variance in the dependent variables could be considered predictable from the independent variables.Results:The joint collaborative characteristics predicted 27% (r2 = 0.27) of the learning variance, which meant that the remaining 73% of the predicted variance was unaccounted for. The perceived learning items predicted 34% (r2 = 0.34) of the usefulness variance.Conclusion:This study found a moderately strong statistically significant relationship between participation in Norwegian maritime crisis collaboration exercises and perceived levels of learning and usefulness. More focus on collaboration learning techniques in exercise planning and evaluation is recommended.

A Deeper Look into Exercise Intensity Tracking through Mobile Applications: A Brief Report

Mobile fitness applications (apps) allow for time-efficient opportunities for physical activity. Current research suggests that fitness apps do not accurately comply with the frequency, intensity, time, and type (FITT) principle. FITT is an important principle in exercise prescription as it applies scientific evidence to improve the quality of exercise. Based on app assessment using the Fitness Apps Scoring Instrument, most fitness apps adequately address FITT in their exercise plans. In particular, fitness apps do not adequately adhere to the FITT intensity guidelines. Many apps allow the users to track their heart rate as a method of assessing their exercise intensity, but few use that information to provide real-time feedback on the intensity of the workout. For app users, awareness and education of intensity standards should be put forth in coordination with exercise professionals, rather than relying on apps alone.

Self-efficacy resources program for behavior changes

Self-efficacy resources program for behavior changes