Exercise Research Articles

Sexual Function of Women with and without Pregnancy-Related Pelvic Girdle Pain and its Relationship with Physical Activity, Kinesiophobia and Body Image: A Cross-Sectional Comparative Study.

The aim of this study was to compare the sexual function of women with and without pregnancy-related PGP, and to investigate its relationship with physical activity (PA), kinesiophobia, and body image (BI). Demographic characteristics, sexual function (Pregnancy Sexual Response Inventory), PA (Pregnancy Physical Activity Questionnaire), kinesiophobia (Tampa Kinesiophobia Scale), and BI (Body Image in Pregnancy Scale) of 125 pregnant women were recorded. In the PGP group (n = 46), visual analogue scales were used to assess the pain intensity during resting and sexual activity, and Pelvic Girdle Questionnaire was used to evaluate the activity limitation. Although total sexual function and BI scores of the groups were similar (p > 0.05), dyspareunia during pregnancy and level of kinesiophobia were higher, and energy expenditure during moderate-intensity PA was lower in pregnant women with PGP (p < 0.05). The PGP group had moderate activity limitation and reported increased PGP intensity during sexual activities (p < 0.001). PA level was significantly correlated with sexual desire (r = 0.180), and overall sexual function was correlated with kinesiophobia (r = -0.344) and BI (r = -0.199) during pregnancy (p < 0.05). These findings suggest that pregnant women with PGP are more vulnerable to sexual dysfunctions, and there is a need to develop biopsychosocial framework-oriented management strategies which aim to improve PA level and to eliminate psychological factors such as kinesiophobia and negative BI.Clinical Trial Registration: NCT05990361.

Adolescent Lifestyle Behaviour Modification and Mental Health: Longitudinal Changes in Diet, Physical Activity, Sleep, Screen Time, Smoking, and Alcohol Use and Associations with Psychological Distress

AbstractThis study examines longitudinal behaviour change in six key lifestyle behaviours—sleep, physical activity (PA), sedentary recreational screen time, diet, alcohol use, and tobacco use—and associations with mental health in a large study of Australian adolescents. Change between baseline (Mage = 12.7, N = 6,639) and 3-year follow up (Mage = 15.7, N = 4445) was investigated. Generalised linear mixed effects regressions modelled associations between behaviour change and later psychological distress score adjusting for baseline behaviours, baseline psychological distress, social determinants, and school clustering. Changes over time in each of the behaviours were significantly associated with later psychological distress, whereby health-promoting behaviours were associated with reduced psychological distress and vice versa. When all behaviour changes were modelled together, significant effects remained for sleep, PA, vegetable consumption, junk food and SSB consumption, alcohol, and tobacco use. Results highlight the potential benefits of behaviour modification to reduce the progression of psychological distress in adolescence.

Acceptance of a mobile telepresence robot used to teach adapted physical activity to isolated older adults: extending and testing the technology acceptance model

This study aimed to investigate the acceptance of adapted physical activity (APA) by teachers and students before the use of a mobile telepresence robot (MTR), used to remotely supervise isolated older adults’ physical activity. While previous studies have shown MTR to be fairly well accepted by older adults, nothing is known about its acceptance by APA teachers themselves. However, if they did not accept it, the MTR would not be used in the end. This would be a public health issue because isolated older adults would not benefit from supervised APA, yet beneficial to their health. To this end, 334 participants answered a survey that measured different psychological variables, based on the technology acceptance model (TAM). Student’s t-tests and structural equation modeling were used for data processing. Results showed that, before use, there was not any significant difference between teachers’ and students’ acceptance of the MTR. Then, perceived usefulness for teaching APA, perceived ease of use, perceived enjoyment, and intention to use the MTR were lower than the mean of the scale, while perceived usefulness for older adults was higher than the mean of the scale. Finally, this study has validated an extended version of the TAM (including the need for competence and MTR self-efficacy), which allowed it to explain 84.3% of the variance of the students’ and APA teachers’ intention to use the MTR for teaching APA to isolated older adults. Initial obstacles to the use of the MTR seem to exist on the part of APA teachers, prior to their first use, whereas this is not the case for older adults. APA teachers’ acceptance should therefore be investigated in future studies to examine whether this trend is confirmed after the effective use of the MTR.

Music’s Effects on the Environmental Conditions of Physical Activity During Spike Ball Play

Physical education (PE) has the potential to educate students to spend a lifetime in physical activity. An up-and-coming activity that has this potential of lifetime activity is spike ball. Generally, spike ball is played with four players with teams of two. The ball is put into play and the players can move anywhere they want. The objective is to hit the ball into the net so that the opposing team cannot return it. Spike ball presents itself to be an activity for students in high school and col-lege/university. One aspect of increasing activity during spike ball is music being played. Research dealing with music in physical activity settings has found it to enhance endurance and color how people inter-pret fatigue. Thus, the purpose of this study was to examine the effects of music on PA rates (measured via pedometer) of college students as they play spike ball. Generally, it was learned that music had a positive effect on increased amounts of steps taken and time in activity during spike ball play.

A narrative review of anxiety regulation in PhD students based on Green model

To gain a better understanding of the factors that contribute to anxiety among PhD students and the reasons for poor regulation in the current situation, this paper analyses the existing literature on anxiety among PhD students using Green's model. It also compares and evaluates various methods of regulating anxiety. The literature review to extract information on the causes and levels of anxiety, methods and outcomes of anxiety intervention and regulation, and to make comparisons. The study reveals that the phenomenon of PhD students' anxiety has intensified globally in recent years, especially after the end of the epidemic. PhD students experience anxiety due to research pressure, economic pressure, future development, and interpersonal pressure. The main influencing factors are currently the relationship with the supervisor, development prospects, social support, and peer comparison. Among the stress relief methods, the regulation of self-relaxation was found to have better effects on mild anxiety, such as positive thinking, meditation, yoga and physical exercise can be helpful for emotion release then help focus on problem solved. Whereas severe anxiety may require institutional and pharmacological support, also including using psychological therapy such as behavioral cognitive therapy and systematic desensitization methods. For university, competence to provide course-assisted guidance, such as writing groups, peer support, and time management, is also important. Academic communities should pay attention to the guidance on academic fairness. However, PhD students are often unaware of the resources available to them for coping with stress and may not take the initiative to seek psychological counseling or institutional assistance. Therefore, PhD students should receive support from various sources, be guided to express their thoughts, and receive additional education and academic assistance to manage stress. This will enhance their confidence and aid in improving their scientific research.

Impact of a fundamental movement skills program on educator practice in early learning centres

IntroductionEarly development of fundamental movement skills (FMS) has various health, social, emotional, cognitive, and physical benefits. However, reports indicate children’s motor skill proficiencies are diminishing. Therefore, the early childhood years and early childhood educators are vital for providing opportunities for FMS development, which may enable children to acquire a lifelong positive relationship with physical activity (PA).MethodsEducators at early learning centres (ELC) in a regional city were invited to participate in semi-structured interviews and complete a FMS diary. Following the initial data collection, a university student-led FMS focused PA program was delivered. After the completion of the program, educators were invited to participate in a follow-up interview and to complete another FMS diary. The interviews were thematically analysed and the FMS diaries were descriptively reported.ResultsFrom pre-program interviews, three themes were identified including “educator training and recall”, “environmental moderators”, and “expanding knowledge”. Educators indicated they had some formal training regarding physical education, but their knowledge was limited or difficult to recall. Educators suggested increasing their knowledge would be a valuable future enabler to advance FMS outcomes. After the completion of the program, interviews with the educators identified “program impact on practices” as another surfacing theme and is indicative the program elicited reflection of educators about their practices.ConclusionA university student-led FMS focused program provoked reflective practices of educators about FMS proficiency and programming. Educators identified challenges, enablers, and opportunities for facilitating FMS activities at ELC.

Exploring the complex associations among risks of malnutrition, sarcopenia, and frailty in community-dwelling older adults

BackgroundMalnutrition, sarcopenia, and frailty are age-related conditions that are associated with multiple health-related negative outcomes. However, the complex associations between them remain to be elucidated. The aims of the study were to explore: (1) whether the risk of sarcopenia has a mediator effect on the association between risks of malnutrition and frailty; and (2) whether physical activity (PA) level modulates this mediator effect in community-dwelling older adults.MethodsThis cross-sectional study involved 593 older adults (62.73% female; mean age = 71.35 ± 5.86 years). The Mini Nutritional Assessment-Short Form (MNA-SF), the SARC-F Questionnaire, and the FRAIL Questionnaire were used to assess the risks of malnutrition, sarcopenia, and frailty, respectively. The International Physical Activity Questionnaire Short Form (IPAQ-SF) was employed to assess PA level. Using the Hayes PROCESS macro (Models 4 and 7), mediation and moderated mediation analyses were performed.ResultsThe mediation analysis demonstrated that the MNA-SF had a significant effect on the SARC-F (B=-0.325; p < 0.001) and the SARC-F, in turn, had a significant effect on the FRAIL (B = 0.341; p < 0.001). The total (B=-0.171; p < 0.001), direct (B=-0.061; p = 0.001), and indirect (B=-0.111; bootstrap CI did not include zero, which indicates a significant effect) effects of MNA-SF on FRAIL were significant, showing that 65% of the association between the MNA-SF and FRAIL was explained by the SARC-F acting as a mediator. The moderated mediation analysis demonstrated that the association between MNA and SARC-F was moderated by the PA level (B = 0.253; p = 0.016). The SARC-F mediated and relatively enhanced the association between MNA-SF and FRAIL only in older adults with a moderate PA level (B=-0.120; CI: -0.154 to -0.085).ConclusionsThe SARC-F partially mediates the association between the MNA-SF and the FRAIL, indicating that malnutrition affects frailty through an indirect path via sarcopenia. Furthermore, the PA level moderates this mediator effect, with sarcopenia serving as a mediator in older adults with moderate a PA level but not in those with a low PA level. These findings reveal that it may be beneficial to consider PA level in combination with malnutrition and sarcopenia in the management and prevention of frailty in community-dwelling older adults.

Patient and carer experiences of cancer cachexia and its management.

To explore the contributions of recent qualitative literature in progressing understanding of the experiences of cancer cachexia, and its management, from the perspectives of patients and unpaid/family carers. Challenges with conducting everyday activities, maintaining independence, and continuing usual roles within the family are sources of distress. Patients and carers value individualization, flexibility, and carer involvement in physical activity/exercise interventions. In psychosocial/educational interventions that were positively perceived, the opportunity to talk about cachexia was appreciated, leading to improved health literacy, awareness about nutrition, and relationships with food. However, the general patient and carer experience around clinical acknowledgement and management of cachexia remains poor. Eating-related distress and conflicts, lack of understanding about cachexia, and the visibility of weight loss remain recurring themes amongst literature on experiences of cancer cachexia. Studies exploring preferences for, and experiences of, interventions have primarily focused on physical activity or exercise. Psychosocial/educational and physical activity/exercise interventions are valued and perceived to alleviate some of the key quality of life issues amongst patients with cancer cachexia and their unpaid/family carers.

The PompeQoL questionnaire: Development and validation of a new measure for children and adolescents with Pompe disease.

Genetic disorders pose great challenges for affected individuals and their families, as they must cope with the irreversible nature of the disease and a life-long dependence on medical assistance and treatment. Children and adolescents dealing with Pompe disease (PD) often struggle to keep up with their peers in physical activities. To gain valuable insights into their subjective experiences and better understand their perception and coping related to daily challenges linked to their condition and treatment, the use of standardized questionnaires is crucial. This study introduces the novel PompeQoL 1.0 questionnaire for children and adolescents with PD, designed for comprehensive assessment of both disease-specific FDH and HRQoL through self- and proxy reports. Content validity was ensured through patients' and parents' involvement at the initial stages of development and in subsequent cognitive debriefing process. Participants found the questionnaire easy to understand, answerable, relevant, and comprehensive. Adjustments based on feedback from patients and their parents improved its utility as a patient- and observer-reported outcome measure. After careful item examination, 52 items were selected, demonstrating moderate to excellent test-retest reliability for most scales and initial evidence for satisfactory construct validity. The PompeQoL questionnaire stands as a valuable screening instrument for both clinical and research purposes. Future research should prioritize additional revisions and larger validation studies, focusing on testing the questionnaire in clinical practice and trials. Nevertheless, the PompeQoL 1.0 stands out as the first standardized measure providing insights into disease-specific FDH and HRQoL among children and adolescents with various forms of PD.

Identifying determinants for falls among Iranian older adults: insights from the Bushehr Elderly Health Program

BackgroundFalls are a common cause of fractures in older adults. This study aimed to investigate the factors associated with spontaneous falls among people aged ≥ 60 years in southern Iran.MethodsThe baseline data of 2,426 samples from the second stage of the first phase of a prospective cohort, the Bushehr Elderly Health (BEH) program, were included in the analysis. A history of spontaneous falls in the year before recruitment was measured by self-report using a standardized questionnaire. Demographic characteristics, as well as a history of osteoarthritis, rheumatoid arthritis, low back pain, Alzheimer’s disease, epilepsy, depression, and cancer, were measured using standardized questionnaires. A tandem gait (heel-to-toe) exam, as well as laboratory tests, were performed under standard conditions. A multiple logistic regression model was used in the analysis and fitted backwardly using the Hosmer and Lemeshow approach.ResultsThe mean (standard deviation) age of the participants was 69.34 (6.4) years, and 51.9% of the participants were women. A total of 260 (10.7%, 95% CI (9.5–12.0)%) participants reported a spontaneous fall in the year before recruitment. Adjusted for potential confounders, epilepsy (OR = 4.31), cancer (OR = 2.73), depression (OR = 1.81), low back pain (OR = 1.79), and osteoarthritis (OR = 1.49) increased the risk of falls in older adults, while the ability to stand ≥ 10 s in the tandem gait exam (OR = 0.49), being male (OR = 0.60), engaging in physical activity (OR = 0.69), and having high serum triglyceride levels (OR = 0.72) reduced the risk of falls.ConclusionThe presence of underlying diseases, combined with other risk factors, is significantly associated with an increased risk of falls among older adults. Given the relatively high prevalence of falls in this population, it is crucial to pay special attention to identifying and addressing these risk factors.

Sustainable pre-treatment of cellulose knitwear in digital pigment printing processes

PurposeIn the field of research on the application of digital printing to textile materials, there are still many research issues that arise from the very demanding interaction of digital printing technology and the complex, heterogeneous surface system of textile materials. This is precisely why the area of pre-treatment of textile materials is in need of research, and the purpose of this research was to establish the level of influence of physical and chemical activation of the textile surface with plasma and the possibility of improving the quality of the print and colour reproduction.Design/methodology/approachThe paper deals with the possibility of applying argon and oxygen cold low-pressure plasma in the processing of cellulose knitted fabrics, with the aim of improving the quality of the print and colour reproduction in digital pigment inkjet printing. The selected raw material samples were 100% raw cotton and lyocell. After plasma treatment, the samples were printed by digital ink jet printing with water-based pigment printing ink. An analysis of the micromorphological structure of untreated and plasma-treated samples before and after printing was carried out, and a comparative analysis of the colour of the printed elements was carried out depending on the pre-treatment.FindingsThe conducted research showed a positive influence of plasma pre-treatment on the coverage of the fibre surface with pigments, the uniformity of pigment distribution along the fibre surface and the uniformity of the distribution of the polymeric binder layer. This has a positive effect on colour reproduction. Also, certain improvements in colourfastness to washing were obtained.Research limitations/implicationsConsidering the complexity of the topic, although exhaustive, this research is not sufficient in itself, but opens up new questions and gives ideas for further research that must be carried out in this area.Practical implicationsAlso, this kind of research contributes to the possibility of adopting the idea of industrial plasma transformation, as an ecologically sustainable functionalisation of textiles, which has not yet been established.Originality/valueThis research is certainly a contribution to the establishment of acceptable textile pre-treatment methods in the field of digital printing, as one of the key quality factors in digital textile printing (DTP). Considering the still large number of obstacles and unanswered questions encountered in the field of digital printing on textiles, this kind of research is a strong contribution to the understanding of the fundamental mechanisms of the complex interaction between printing ink and textile.

Self-Care in Nursing Professionals during the COVID-19 Pandemic: An Integrative Review

Introduction: The COVID-19 pandemic posed unprecedented challenges to the nursing staff, who were at the forefront of patient care and their families. Exposed to the virus due to strenuous work schedules and other factors, their health was at risk. However, they took proactive self-care actions to counteract these factors, promote self-health, and prevent the onset of diseases caused by stressors from the pandemic. These actions, identified in the literature published between 2020-2023, have significantly impacted their individual and collective health. Objective: To identify the self-care strategies implemented by nursing professionals during the COVID-19 pandemic and to analyze them in the light of Giddens’ theoretical proposal. Materials and methods: An integrative literature review under a descriptive scope was conducted between June and September 2023 in the following databases: Pubmed, Scielo, Science Direct, Lilacs, and Google Scholar; also, PRISMA recommendations were taken into account for the organization of the search. Results: 40 articles, published between 2020 and 2023 and representing for different methodological designs, were included in the review. The self-care implemented by nurses during the pandemic was assessed in the light of Giddens’ theoretical proposal under two types of actions: intentional, which account for physical, mental, and emotional health care activities, and deliberate, which focus on care at a social level. Conclusions: The identified self-care actions were oriented toward the promotion of individual and collective health of workers, the reduction of employee turnover, the recognition of stress, and the strengthening of resilience, which can also be implemented nowadays.

Restoring Skeletal Muscle Health through Exercise in Breast Cancer Patients and after Receiving Chemotherapy

Breast cancer (BC) stands out as the most commonly type of cancer diagnosed in women worldwide, and chemotherapy, a key component of treatment, exacerbates cancer-induced skeletal muscle wasting, contributing to adverse health outcomes. Notably, the impact of chemotherapy on skeletal muscle seems to surpass that of the cancer itself, with inflammation identified as a common trigger for muscle wasting in both contexts. In skeletal muscle, pro-inflammatory cytokines modulate pathways crucial for the delicate balance between protein synthesis and breakdown, as well as satellite cell activation and myonuclear accretion. Physical exercise consistently emerges as a crucial therapeutic strategy to counteract cancer and chemotherapy-induced muscle wasting, ultimately enhancing patients’ quality of life. However, a “one size fits all” approach does not apply to the prescription of exercise for BC patients, with factors such as age, menopause and comorbidities influencing the response to exercise. Hence, tailored exercise regimens, considering factors such as duration, frequency, intensity, and type, are essential to maximize efficacy in mitigating muscle wasting and improving disease outcomes. Despite the well-established anti-inflammatory role of aerobic exercise, resistance exercise proves equally or more beneficial in terms of mass and strength gain, as well as enhancing quality of life. This review comprehensively explores the molecular pathways affected by distinct exercise regimens in the skeletal muscle of cancer patients during chemotherapy, providing critical insights for precise exercise implementation to prevent skeletal muscle wasting.

The Prospect of Probiotics to Treat Metabolic Syndrome

Metabolic syndrome remains as a major health problem in the world today, with a prevalence of 23.4% in people aged 26-82 years. A high-fat, high-carbohydrate diet and lack of physical activity are considered as one of the triggers for metabolic syndrome. Dysbiosis is a condition where there is an imbalance between pathogenic and non-pathogenic bacteria in the human gut. Currently, an association has been found between dysbiosis and metabolic syndrome. Dysbiosis causes the generation of fermentation products in the form of active metabolites that can modulate hormones and other physiological functions. In metabolic syndrome, low-grade inflammation, energy metabolism, and disruption of the gut brain axis are thought to be the main mechanisms of the development of metabolic syndrome due to dysbiosis. Probiotics may be a promising therapeutic agent in the treatment of metabolic syndrome, by improving dysbiosis to eubiosis. Based on previously conducted clinical trials, it is currently known that probiotics can improve lipid profiles, fasting blood glucose, homeostatic model assessment for insulin resistance (HOMA-IR), vascular cell adhesion molecule 1 (VCAM-1), glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and body mass index (BMI). However, the results found are still varied, so a dose ranging study is needed to determine the duration, bacterial composition and dose of probiotics as a therapeutic agent for metabolic syndrome. Keywords: insulin resistance, dysbiosis, gut-brain axis

Physical Activity Interventions in People with Diabetes: A Systematic Review of The Qualitative Evidence

Physical Activity Interventions in People with Diabetes: A Systematic Review of The Qualitative Evidence

Parent/carer experiences and challenges in redeeming the First Lap swimming lesson voucher in New South Wales, Australia

ABSTRACT Rationale Swimming is a popular, enjoyable, and important form of physical activity. Swimming skills play a vital role in water safety and drowning prevention, particularly among young children. The First Lap program is a New South Wales government swimming lesson subsidy voucher program for preschool-aged children. This study examined parent/carer program views and experiences in 2021–2022, specifically reasons for voucher non-redemption. Approach A thematic analysis examined 1031 parent/carer qualitative responses concerning reasons for voucher non-redemption and overall views and experiences of the program in an online parent/carer survey.Findings: Voucher non-redemption was evident through: seasonal, weather and health; program parameter; parent/carer (user); and swim school (provider) themes. Despite non-redemption, parent/carer program views were additionally evident through: positive feedback about the program and its objectives; evidence of knowledge and awareness of the importance of water safety and learning to swim; lesson affordability concerns. Practical implications Swim school and lesson availability, accessibility, and affordability can be addressed through clear engagement and communication with both the user and provider sides. Research contribution Reasons for First Lap voucher non-redemption represent barriers to swimming lesson participation for preschool-aged children. Originality Voucher programs must consider the impacts of the broader socio-ecological context and ecosystem.

The relationship between parental anxiety, fear of Covid‐19, partner involvement in children's care and sleep quality during the Covid‐19 pandemic in Italy

AbstractDuring the Covid‐19 pandemic new stressors were added to the usual challenges parents face, changing habits and reduced physical activity, all factors that negatively affect sleep quality in adults and children. This study examines (1) possible changes in the sleep‐wake patterns of parents and children before and after the March–May 2020 lockdown and during the new restrictions imposed by the Italian government in March 2021; (2) possible associations between children and parents' sleep quality reported by parents and intrinsic and extrinsic factors. A total of 264 Italian parents with children aged 1–6 years (M = 40 months, SD = 18.18) completed self‐report questionnaires. Children's sleep habits changed, and parental insomnia symptoms worsened after the March–May 2020 lockdown, while children's insomnia symptoms decreased. Positive associations between children's negative affectivity and insomnia symptoms emerged, as well as between generalized parental anxiety and parental insomnia symptoms and between parental fear of Covid‐19 and sleep‐related habits not in line with paediatric recommendations. Partner's involvement in children's care promoted good sleep habits. Results identified risks and protective factors that could impact Italian parents' and children's sleep during the second wave of the Covid‐19 pandemic, raising awareness among families, education practitioners, healthcare providers and the general public.Highlights Italian children's sleep habits changed, and parental insomnia symptoms worsened after the March–May 2020 lockdown, while children's insomnia symptoms decreased. During the second wave of the Covid‐19 pandemic, higher levels of children's temperamental negative affectivity were associated with higher levels of parental and children's insomnia, higher levels of parental anxiety, and the presence of children's sleep‐related habits not in line with pediatric recommendations. Partner's involvement in children's care promoted good and healthy children's sleep habits.

The effect of exercise and educational programs for breast cancer patients on the development of breast cancer-related lymphoedema: secondary endpoint from a randomized controlled trial in the Setouchi Breast Project-10.

Although the association between higher physical activity and preventive effect on breast-cancer-related lymphoedema (BCRL) has been reported, it is unclear what intervention is optimal. We aimed to investigate the effect of exercise and educational programs on BCRL development. This study was a secondary endpoint analysis from a prospective randomized controlled trial. We enrolled patients with stage 0-III breast cancer from March 2016 to March 2020 and randomly assigned them to the control (n = 111), education (n = 115), or exercise (n = 104) group. As secondary endpoint, we assessed the incidence of and preventive effect on BCRL at 12months post-intervention. There were no significant differences in the incidence of BCRL at 12months post-intervention between the exercise and control groups (9.8% and 10.8%, P = 0.83) and the education and control groups (11.6% and 10.8%, P = 1.00). There were no significant differences in time to BCRL onset from the day of surgery between the exercise and control groups (event rate at 12months: 20.7% and 17.2%, log-rank, P = 0.54) and the education and control groups (18.8% and 17.2%, log-rank, P = 0.57). The multivariable analyses indicated that axillary dissection and obesity significantly increased the risk of BCRL [hazard ratio (HR): 2.36, 95% confidence interval (CI) 1.52-3.67 and HR: 1.68, 95% CI 1.07-2.63, respectively]. The intervention did not decrease the risk of BCRL, and axillary dissection and obesity were the risk factors of BCRL. UMIN000020595 at UMIN Clinical Trial Registry.

Pilot Study of Home-Based Virtual Reality Fitness Training in Post-Discharge Rehabilitation for Patients with Spinal Cord Injury: A Randomized Double-Blind Multicenter Trial

Spinal cord injury (SCI) patients require continuous rehabilitation post-discharge to ensure optimal recovery. This study investigates the effectiveness of home-based virtual reality fitness training (VRFT) as a convenient and accessible rehabilitation method for SCI patients. This randomized, double-blind, multicenter trial will enroll 120 participants, assigning them to either an 8-week VRFT program (exercise group) or a control group engaging in regular daily activities. The outcomes measured include muscle function, cardiopulmonary fitness, body composition, and physical performance. Our study will determine the safety and feasibility of VRFT in a home setting for SCI patients and evaluate whether these patients can effectively participate in such a program post-discharge. The results of this study are expected to inform future exercise protocols for SCI rehabilitation, offering valuable insights into the utility of VRFT as a therapeutic tool.

The combined association of physical activity and alcohol use with long-term mortality: an age-stratified analysis

BackgroundThe combined association of physical activity (PA) and alcohol use (AU) with long-term mortality is yet to be investigated.MethodsFor the current study, 12,621 participants aged ≥ 20 years were enrolled from the National Health and Nutrition Examination Survey (1999–2004). The study endpoint was all-cause mortality. Cox proportional hazards regression models were used to examine the combined effect of PA and AU on long-term mortality.ResultsThe study population was divided into young (< 60 years, N = 8,258) and old (≥ 60 years, N = 4,363) groups. The median follow-up time was 203 months. In both young and old group, sedentary lifestyle combined with even minimal AU were associated with elevated risk of death (all P < 0.05). In young group, the integration of high volume AU with any degree of PA, including sedentary PA (HR = 2.35, 95% CI 1.24–4.44, P = 0.009), low PA (HR = 1.64, 95% CI 1.01–2.68, P = 0.047), and moderate-to-vigorous PA (HR = 1.99, 95% CI 1.03–3.84, P = 0.041), was associated with an increased risk of mortality. This relationship persisted as significant after adjusting for potential confounders (all P < 0.05). In old group, combining moderate-to-vigorous PA and low volume AU (HR = 0.59, 95% CI 0.37–0.94, P = 0.027) was associated with a reduction in mortality. After adjustment, the combination of moderate-to-vigorous PA and low volume AU was independently associated with favorable prognostic outcomes (all P < 0.05).ConclusionsIn both age groups, combining sedentary lifestyle with even minimal AU was a risk factor for death. In young group, combining any level of PA with high volume AU was associated with increased mortality. In old group, combining moderate-to-vigorous PA with low volume AU was related to reduced mortality.