Four-week Intervention Period Research Articles

Effects of Foot Position-Based Gait Training on Muscle Activity, Gait Parameters, and Balance in Subacute Stroke Patients

Background: the effects of gait training based on the positioning of affected foot muscle activity, gait parameters, and balance ability were investigated in patients with subacute stroke. Material and Methods: Forty-five patients with subacute stroke were randomly assigned to three groups: straight gait training (SGT) group (n = 15), outward curved gait training group (OCGT) with the paretic foot positioned laterally (n = 15), or inward curved gait training (ICGT) group with the paretic foot positioned medially (n = 15). All groups received 30 min interventions, comprising 15 min of gait training, five times per week for four weeks. Outcomes were measured in terms of muscle activation of the gluteus maximus (GM), vastus medialis, and vastus lateralis; five gait parameters (step length, stance phase, swing phase, velocity, and maximum force); and balance ability assessed using the timed up and go (TUG) test. Results: All groups exhibited significant improvements in all variables after the four-week intervention period (p < 0.05). Specifically, the overall muscle activation and gait parameters for each group increased as follows: the SGT showed increases of 38.8% and 5.7%, respectively; the OCGT exhibited improvements of 38.9% and 7.4%; and the ICGT demonstrated enhancements of 59.8% and 9.2%. However, except for comparisons between the SGT and ICGT groups in terms of GM muscle activity and TUG, no significant differences were observed between the groups for the other variables (p > 0.05). Conclusions: although patients with subacute stroke can improve their overall physical function regardless of the gait training method, ICGT may be more effective in enhancing muscle activity and balance ability.

Gender differences in effects of Graston technique, active release technique, and PNF stretching on hamstring flexibility in knee osteoarthritis

Aims. To seek gender differences among the effects of the Graston Technique (GT), Active Release Technique (ART), and Proprioceptive Neuromuscular Facilitation (PNF) stretching on hamstring flexibility, pain, lower extremity function, and physical function in patients with knee osteoarthritis. Materials and methods. A multicenter, single-blind randomized controlled trial was conducted involving 45 patients – aged above 30 years with knee osteoarthritis – randomly allocated to three equal groups: Group-A (GT), Group-B (ART), and Group C (PNF). Each group received 12 physiotherapy sessions over a four-week intervention period (3 visits per week). Data were collected before and after rehabilitation using the Numeric Pain Rating Scale, Active Knee Extension Test, Lower Extremity Function Scale, and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Results. A statistically significant interaction between the effects of gender and Active Release Technique on lower extremity function was present (p < 0.001) with males (42.4 ± 2.2) showed more improvement than females (35.6 ± 6.6). On the contrary, females showed more improvement (p < 0.001) than males when Graston Technique and PNF techniques were applied. Conclusion. There were no significant gender-based differences among GT, ART, and PNF regarding pain, hamstring flexibility and WOMAC score. However, males showed significantly more improvement in lower extremity function than females with ART, and females showed more improvement in lower extremity function as compared to males with GT and PNF.

Tracking the Risk of Cardiovascular Disease after Almond and Oat Milk Intervene or Statin Medication with a Powerful Reflex SH-SAW POCT Platform.

Cardiovascular disease (CVD) represents the leading cause of death worldwide. For individuals at elevated risk for cardiovascular disease, early detection and monitoring of lipid status is imperative. The majority of lipid measurements conducted in hospital settings employ optical detection, which necessitates the use of relatively large-sized detection machines. It is, therefore, necessary to develop point-of-care testing (POCT) for lipoprotein in order to monitor CVD. To enhance the management and surveillance of CVD, this study sought to develop a POCT approach for apolipoprotein B (ApoB) utilizing a shear horizontal surface acoustic wave (SH-SAW) platform to assess the risk of heart disease. The platform employs a reflective SH-SAW sensor to reduce the sensor size and enhance the phase-shifted signals. In this study, the platform was utilized to monitor the impact of a weekly almond and oat milk or statins intervention on alterations in CVD risk. The SH-SAW ApoB test exhibited a linear range of 0 to 212 mg/dL, and a coefficient correlation (R) of 0.9912. Following a four-week intervention period, both the almond and oat milk intervention (-23.3%, p < 0.05) and statin treatment (-53.1%, p < 0.01) were observed to significantly reduce ApoB levels. These findings suggest that the SH-SAW POCT device may prove a valuable tool for monitoring CVD risk, particularly during routine daily or weekly follow-up visits.

REGULAR LOW-DOSE CAFFEINE SUPPLEMENTATION DURING TRAINING DOES NOT PROVIDE ADDITIONAL BENEFIT TO SUBSEQUENT EXERCISE PERFORMANCE IN AUSTRALIAN RULES FOOTBALL ATHLETES

INTRODUCTION &amp; AIMS Acute caffeine supplementation can improve exercise types like those completed by Australian Rules football (ARF) players during training. Hypothetically athletes could implement caffeine supplementation prior to training, allowing them to complete more training volume, improving adaptation and subsequent exercise performance. This study aimed to investigate the effect of regular low-dose caffeine ingestion pre-training during a training block on subsequent exercise performance. METHODS Twenty-nine male semi-professional ARF players were randomly allocated to a caffeine or placebo group. The four-week intervention period involved participants ingesting 2 mg·kg·BM-1 of caffeine or a placebo 60 min prior to two of their three weekly training sessions, which incorporated sport-specific conditioning and skills training. To assess exercise performance, a battery of tests was used before and after the intervention period including the Yo-Yo Intermittent Recovery Test Level 2 (YYIRT2), 20 m sprint and vertical jump (VJ). Performance differences were assessed using a linear mixed-effect model. RESULTS Mean session rating of perceived exertion (p = .24) and total training load (p =.53) were not different between caffeine and placebo groups over the intervention. There were no significant time x condition interaction effects for YYIRT2 accumulated distance (p = .87), or 5, 10 and 20 m sprint times (p =.06 - .44), however both caffeine and placebo groups improved YYIRT2 distance and sprint times following four weeks of training (p &amp;lt; 0.01). There was a significant effect for time showing decreased VJ performance (p &amp;lt; 0.01), with greater reductions in the placebo group (p = .03). CONCLUSION It is more beneficial to implement an effective training program for athletes rather than focusing effort on regular low-dose caffeine supplementation to augment the training stimulus. The training stimulus itself is typically greater for developing endurance and sprint effort performance, with supplemental caffeine showing no additional performance benefit.

Efficacy and Safety of Two Chondroprotective Supplements in Patients With Knee Osteoarthritis: A Randomized, Single-Blind, Pilot Study.

Background: Hyaluronic acid (HA), glucosamine (Glc), and chondroitin sulfate (CS) are key ingredients commonly incorporated into dietary chondroprotective supplements for the management of osteoarthritis (OA). Despite their widespread use, there is a paucity of published data regarding their efficacy and safety, necessitating rigorous investigation in clinical settings. To address this knowledge gap, we conducted a randomized, single-blindpilot study to evaluate the effects of two commercially available multi-ingredient supplements on patients with mild-to-moderate knee OA. Methods: A total of 51 patients diagnosed with mild-to-moderate knee OA were enrolled in a four-week randomized study and allocated equally (1:1:1 ratio) into three groups: a control group (n = 17) that received no treatment, an HA group (n = 17) given Syalox® 300 Plus (1 tablet/day) containing HA (300 mg) and Boswellia serrata extract (100 mg), and a Glc + CS group (n = 17) given Cartijoint® Forte (1 tablet/day) containing Glc (415 mg), CS (400 mg), and curcuminoids from rhizomes of Curcuma longa L (50 mg).Physicians conducting evaluations were blinded to group assignments, whereas patients were not. All participants underwent assessments of pain relief, functional capacity improvement, and serum adropin levels, an emerging biomarker of knee OA, at baseline and after the four-week intervention period. Results: Both the HA and the Glc + CS groups exhibited improvements at the end of the study relative to baseline, with statistically significant differences (p < 0.05) observed in pain at rest, pain during movement, range of motion, and the overall Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, including its pain, stiffness, and physical function subscales. Notably, the HA group outperformed the Glc + CS group in the alleviation of pain at rest, pain during movement, and on the WOMAC pain subscale, with all differences being statistically significant (p < 0.05). Additionally, both groups showed a significant elevation in serum adropin levels from baseline (p < 0.05), with the HA group experiencing a more substantial increase when compared to the Glc + CS group (p < 0.05). Both supplements showed a limited number of treatment-emergent adverse events. Conclusion:Oral supplementation with either HA or Glc + CS demonstrated potential benefits for managing symptoms of mild-to-moderate knee OA. Notably, HA supplementation was associated with greater improvements in pain relief and higher elevations in serum adropin levels compared to Glc + CS supplementation. However, larger-scale and longer-term studies are necessary to further evaluate the safety and efficacy of these dietary supplements within the clinical management arsenal for knee OA.

Machine learning and IoT Based Robotic Solution for Home Wrist Rehabilitation through Motion Capture Enabled Architecture

The present study investigates the effectiveness of an integrated approach that combines machine learning, robotic rehabilitation, and traditional methods for wrist rehabilitation among the hemiparesis population. Subjects with robotic rehabilitation at the four-week intervention period showed the ball’s significant difference in the flexion and extension angles and demonstrated the better overall outcomes from the robotic intervention . The machine learning models, in particular, the artificial neural networks, provided the prediction of rehabilitation outcomes and demonstrated the high accuracy, high precision, high recall, and high F1 score. This study supports the idea of the beneficial effects of combining robotic rehabilitation with machine learning algorithms and supports the notion that the two benefits could bring high synergistic effects above their individual potentials. The report also contributes to the development of the rehabilitation science of wrists, given that few studies have explored the applications of artificial intelligence methods or robotic rehabilitation beyond the context of feasibility reports. The findings of the current research could contribute useful insights for the decision-making practices of therapists and healthcare providers, also given the reliance on large data contributed by the previous interventions. Future study could investigate the long-term results, the cost-effectiveness of the approaches, and assist in developing the potential results of customization for individual patients.

An Open-Label Study of a Wearable Device Targeting ADHD, Executive Function, and Academic Performance.

This was an open-label pilot study to test the feasibility and preliminary efficacy of a wearable digital intervention developed to improve on-task behavior. This was an exploratory study to test for specificity of response on parent- and teacher-reported symptom outcomes in attention and hyperactive/impulsive symptoms, as well as domains of functional impairment, including school behavior and learning and executive function. Participants included 38 children aged 8-12 years with a parent-reported past diagnosis of ADHD. Following baseline ratings from parents (N = 38) and teachers (N = 26), participants wore the device to school for four weeks. Parent and teacher ratings of ADHD symptoms, executive function, and functional impairment were repeated at the end of the four-week intervention period. Statistically significant improvement was seen in the total scores for all parent and nearly all teacher outcomes, with moderate effect size improvements in attention, organization and planning, self-monitoring, school functioning, and teacher-reported academic performance. Preliminary evidence from this open-label pilot study suggests that having a child interact with a wearable device to self-monitor attention is feasible. This exploratory, open-label pilot study found real-world improvement in functional domains, including academic performance. Future research will require a blinded, randomized, controlled trial using an appropriate sham comparator to confirm these findings.

Effects of the Digital Intervention StudentPOWR on the Subjective Wellbeing of Students Studying from Home: a Randomized Wait-List Control Trial

Since the COVID-19 pandemic, the demand to study and work from home has become of great importance. While recent research has provided evidence for the negative influence of remote studying on the mental and physical health of students, less is known about digital well-being interventions to mitigate these effects. This study had two objectives: 1) to assess the effects of the online well-being intervention, StudentPOWR, on the subjective well-being of students studying from home, and 2) to investigate the influence of engagement with the intervention on subjective well-being. This was a non-blind, 3-arm (full access, limited access, and waitlist control) randomized controlled trial (RCT) and took place in March 2021. University students (N = 99) studying remotely in Ireland and the Netherlands were randomly assigned to the full access (N = 36), partial access (N = 30), or waitlist control (N = 33) group for the four-week intervention period. Measures included the SPANE questionnaire for subjective well-being and the DBCI-ES-Ex for engagement with the intervention. Participants in both the full access and the partial access groups improved in their subjective well-being scores from baseline to week 2 compared to the waitlist control group (p = .004, Hedges g equal to 0.4902 - small effect size - and 0.5698 - medium effect size - for the full intervention and partial intervention, respectively). However, post-intervention, participants in the partial intervention – but not in the full access group - showed significantly greater changes in subjective well-being scores compared to those in the waitlist control group. Possible explanations for these results, comparisons with previous studies, and suggestions for future research are explored.

Applying E-Writing Therapy to Improve Mental Wellbeing among Malaysian University Students Following the COVID-19 Pandemic

The COVID-19 pandemic is a global crisis that has significantly impacted people’s lives worldwide, particularly in terms of mental health and wellbeing. The implementation of frequent and restrictive movement control orders has resulted in prolonged online learning for university students. However, limited research has been conducted to test practical interventions aimed at alleviating the negative impact on the mental wellbeing of university students during the pandemic. This mixed-method research study aimed to investigate the usability of e-writing therapy as an intervention tool to improve the mental wellbeing of 40 university students in a public Malaysian higher education institution. A one-group pretest-posttest design was employed, and a mental wellbeing questionnaire based on the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7), and the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) was administered to the participants before and after the intervention. The results of paired-samples t-tests for each instrument indicated that there was no significant improvement in the students’ mental wellbeing after the four-week intervention period. However, qualitative data obtained from the students’ experiences with e-writing therapy revealed that it provided a flexible and personal safe space for emotional expression. It empowered them to address their mental health needs during the post-pandemic era, while minimising concerns about stigma, privacy and confidentiality, despite having certain challenges and concerns. Therefore, there is potential for e-writing therapy to be used as a complementary tool alongside conventional psychological interventions to address mental wellbeing issues among university students.

The Effectiveness of a Hybrid Off-Job Crafting Intervention on Employees&amp;rsquo; Psychological Needs Satisfaction and Well-Being

Off-job crafting entails deliberate changes people can make in their non-work activities to meet their personal goals and satisfy psychological needs. We conducted a quasi-experimental study with a waitlist control group in three organizations in Finland (N = 86) to evaluate whether participation in a hybrid off-job crafting intervention stimulates employees’ off-job crafting efforts and, in turn, enhances psychological need satisfaction, subjective vitality and work engagement. Intervention group participants took part in an off-job crafting workshop, set a personal crafting goal for the four-week intervention period, received support from a specifically designed smartphone app, and attended a reflection workshop. With a study design consisting of seven measurement occasions in the intervention group and four in the waitlist control group, we examined both the intra-individual and inter-individual effects of the intervention. Contrary to our expectations, intervention group participants did not improve in their off-job crafting efforts, needs satisfaction and well-being over time compared to their own baseline and the waitlist control group. We conducted a detailed process evaluation to shed light on the mechanisms possibly influencing the effectiveness of the intervention. Participants who made less progress with their goal, were less satisfied with the intervention, and participants who did not set a goal focusing on their least satisfied need, experienced a steeper decline in off-job crafting, needs satisfaction and well-being. Interestingly, setting a SMARTer goal and being a more active app user also had a negative effect on the development of one’s off-job crafting, needs satisfaction and well-being over time.

Early childhood educator outcomes from online professional development for physical literacy: A randomised controlled trial

IntroductionEarly childhood is recognised as a critical window of opportunity for physical literacy development, however early childhood educators typically lack the training required to effectively provide appropriate physical literacy opportunities for children. We examined the effects of an online physical literacy professional development program—relative to continuing with ‘standard’ practice—on early childhood educators’ physical literacy knowledge and application. MethodsWe conducted a parallel two-arm randomised controlled trial, in which 88 early childhood educators were randomly assigned to an online professional development program designed to support educators’ physical literacy instructional skills (intervention arm; n = 37), or a ‘standard practice’ control condition (n = 51). Data were collected prior to and after the four-week intervention period. We measured educators’ physical literacy knowledge and application (our primary outcome) through independent coding of open-ended survey responses, and educators’ self-reported perceptions of values, confidence, behaviours, and barriers (secondary outcomes). Between-group differences were assessed through analysis of covariance. ResultsOne intervention arm participant withdrew from the study, resulting in 87 participants included in analysis. Educators in the intervention arm scored significantly higher on post-intervention physical literacy knowledge (d = 0.62) and application (d = 0.33) than those in the control arm. Educators in the intervention arm also scored significantly higher than controls on confidence in teaching physical activity (d = 0.42) and significantly lower than controls on perceived personal barriers to physical activity (d = 0.53). Thirteen participants in the intervention arm (36%) did not begin the online professional development program. ConclusionImprovements in physical literacy instructional outcomes indicate the potential for further investigation into broader implementation of online professional development programs of this nature in the future.

Using a smart audio device, Tochie to deliver family messages in long-term care.

Long-term care (LTC) residents are more likely to experience loneliness, social isolation and have dementia (Garner et al., 2018; Hou & Ngo, 2021). The effects of isolation have been exacerbated by the COVID-19 pandemic. While assistive technology has been a popular topic in gerontological health research, there have been limited findings on the experience of technology adoption in complex care environments such as LTC, and on family member and staff perspectives. "Tochie" is a smart audio device that allows family and significant others to remotely record and schedule messages, such as daily reminders or comforting audio recordings, to send to their loved ones in care settings. Our research explores the experiences of residents, families, and staff using the Tochie device in LTC. We applied qualitative descriptive design with interview and focus group methods. 10 residents, 9 family members, and 6 care staff from two long-term care homes in British Columbia, Canada, participated in the study. Each resident was given a device to use with their family member for a four-week intervention period. The research team checked in with family members and staff weekly via telephone and email to provide support and gather feedback. Pre- and post-intervention focus groups and interviews were held via Zoom and phone correspondence to learn about participants' experiences using Tochie. Thematic analysis was performed to identify themes. Four common themes were identified to describe the experience of using Tochie in LTC: (a) Tochie as a means to facilitate emotional connection (b) Using Tochie in creative, personalized ways (c) Challenges and contextual considerations in LTC (d) Ideas for future developments CONCLUSION: The COVID-19 pandemic has provided us an opportunity to redefine and reconstruct what it means to "keep in touch" with loved ones in care settings. In our study, residents, families and staff highlighted the ways in which Tochie has enabled this connection and provided feedback on their challenges and device recommendations. This study explores the valuable perspectives of residents, their loved ones, and care staff in the use of assistive audio devices to inform product development and adoption into LTC.

275 “MOVING ON UP”: FEASIBILITY OF A WARD-BASED THERAPY INITIATIVE TO IMPROVE PATIENT ACTIVITY LEVELS IN NEUROLOGICAL REHABILITATION

Abstract Background Patients admitted for neurological rehabilitation are not receiving sufficient dosage of activity to facilitate optimal recovery. Previous research has reported issues with feasibility and patient adherence to intensity programs. Methods Mixed methods were employed for this feasibility study. The “Moving On Up” program encompassed “Activitea” structured practice of sit to stands prompted by mealtimes, “Step It Up” a gradual walking program using pedometers and “Weekend Workout” increasing practice of exercise programs. These activities were in addition to daily therapy sessions over a four-week intervention period. Primary feasibility outcomes investigated recruitment, retention, adherence, adverse events, facilitators, barriers and acceptability of the program and preliminarily assessed changes in activity levels using the ActivPAL accelerometer. Functional tests assessed mobility, health-related quality of life and fear of falls. Descriptive statistics were used for analysing quantitative data. Braun and Clarke’s thematic analysis was adopted when reviewing qualitative data. Results Ten participants were recruited with zero dropouts. Median age was 72 years and five had a diagnosis of brain tumour excision. Eight participants demonstrated excellent adherence with completion of daily activity logs. There was one participant non-injurious fall, no other adverse events. Clinical outcomes demonstrated improvement in median daily step count, stepping and standing time. The median daily step count for the group increased from 1,375 steps (IQR 2,867, range 82-4,248) to 1,724 steps (IQR 2,914, range 80-8,207). All functional tests improved. Seven participants and three therapists completed semi-structured interviews. Five themes emerged; motivation to move more, empowerment, barriers to increasing activity, weekends long and boring and job satisfaction. Conclusion The “Moving On Up” program was feasible to implement without additional staffing and was accepted by key stakeholders. Future research is warranted into the program's effectiveness, incorporating a larger sample and randomised pilot trial. Inclusion of a follow-up of participants after discharge would be desirable to investigate long-term effects on activity.

Primary school teacher outcomes from online professional development for physical literacy: A randomised controlled trial

IntroductionPrimary (or elementary) school teachers are often relied upon to provide children with opportunities for physical literacy development; however, many of these teachers feel they lack the skills to effectively promote or ‘teach’ physical literacy. We examined the effects of an online physical literacy professional development program—relative to receiving widely-available online resources or continuing with ‘normal’ practice—on primary school teachers’ physical literacy knowledge and application. MethodsA parallel three-arm randomised controlled trial in which 92 primary school teachers were assigned to (a) an online professional development program designed to support teachers’ physical literacy instructional skills (‘intervention’), (b) receive widely-available online physical literacy resources (‘comparison’), or (c) a typical practice ‘control’ condition. Data were collected at baseline and following the four-week intervention period. The primary outcome was teachers’ physical literacy knowledge and application; secondary outcomes included teachers’ self-reported perceptions of confidence, values, and barriers. Between-group differences were assessed using the intention-to-treat principle with analysis of covariance accounting for demographic factors and baseline differences in the focal outcome. ResultsTeachers in the intervention arm scored significantly higher on post-intervention physical literacy knowledge and application than their counterparts in both the control (d = .47, p = .044) and comparison (d = 0.87, p = .007) arms. This pattern of differences was also observed for teachers’ value of physical literacy, autonomy support, and perceived personal barriers. ConclusionTo the best of our knowledge, this is the first adequately powered randomised controlled trial to demonstrate improvements in physical literacy instructional outcomes as a result of primary school teacher participation in targeted online professional development.

Food Reward after a Traditional Inuit or a Westernised Diet in an Inuit Population in Greenland.

The food availability and dietary behaviours in Greenland have changed with increasing Westernisation. Food reward is an important driver of food choice and intake, which has not previously been explored in the Arctic population. The aim of this study was to explore differences in food reward after a four-week intervention period with a traditional Inuit diet (TID) or Westernised diet (WD) in Inuit populations in Northern and Western Greenland. This cross-sectional analysis included 44 adults (n = 20 after TID and n = 24 after WD). We assessed the food reward components, explicit liking and implicit wanting, using the Leeds Food Preference Questionnaire under standardised conditions 60 min after drinking a glucose drink as part of an oral glucose tolerance test after four weeks following a TID or WD. The food intake was assessed using food frequency questionnaires. The intervention groups differed only in implicit wanting for high-fat sweet foods, with higher implicit wanting among the participants following TID compared to WD. Both groups had lower explicit liking and implicit wanting for sweet relative to savoury foods and for high-fat relative to low-fat foods. This exploratory study can guide future studies in Inuit populations to include measures of food reward to better understand food intake in the Arctic.

Intermittent Ambient Cold Exposure Is Not an Effective Obesity Treatment in Mice Housed at Thermoneutrality

Chronic ambient cold exposure has been regarded as a promising obesity treatment given it potently increases energy expenditure. However, few mammals are chronically exposed to cold ambient conditions without reprieve highlighting the need to determine whether more physiologically relevant interventions, such as intermittent ambient cold exposure, could be utilized to treat obesity. Moreover, most preclinical cold exposure work to date has been conducted at housing temperatures below thermoneutrality, unintentionally confounding metabolic outcomes. As such, this study examined whether intermittent ambient cold exposure could abrogate the metabolic impairments of diet-induced obesity, in mice housed under humanized thermoneutral conditions. Eight-week-old male and female C57Bl/6J mice (n ≥ 40/sex) were singly housed, acclimated to thermoneutrality (30 °C), and then weight matched into low-fat (LFD; 10% kcal from fat) or high-fat (HFD; 45% kcal from fat) diet fed groups. Male and female mice were given six weeks to feed on their respective diets before being weight-matched into groups that remained unperturbed (CTRL) or underwent intermittent ambient cold exposure (ICE), respectively. ICE consisted of exposure to 4 °C for one hour/day, five days/week, for four weeks. Mice remained on their respective diets for the entire four-week intervention period, during which time glucose and insulin tolerance were assessed. Following the intervention mice were sedated with sodium pentobarbital and sacrificed by exsanguination of the heart. The epididymal and inguinal white adipose tissue depots (eWAT and iWAT, respectively), the interscapular brown adipose tissue depot (BAT), as well as the liver, triceps, and hypothalamus were excised, snap-frozen in liquid nitrogen, and stored at -80 °C. ICE induced hyperphagia that was rapid in onset and persistent, occurring with every exposure independent of diet. Over time, this exacerbated rather than attenuated HFD-induced obesity in both male and female mice, increasing BAT, eWAT, and iWAT mass as well as cellular lipid deposition. Pair-feeding revealed that these ICE-induced increases in adiposity were energy intake dependent, as the pair-fed, but not ad libitum fed, HFD-ICE group was protected from ICE-induced increases in body mass. Despite exacerbating HFD-induced obesity, ICE improved glucose tolerance, independent of diet, in a sex-dependent manner. The effects of ICE on glucose tolerance were not attributed to improvements in whole-body insulin tolerance, tissue specific insulin action, nor to differences in hepatic insulin clearance. Instead, ICE increased serum concentrations of insulin and C-peptide in response to glucose, suggesting that ICE may improve glucose tolerance by potentiating pancreatic glucose-stimulated insulin secretion. Taken together, this data suggests that intermittent ambient cold exposure, despite improving glucose tolerance, is not an effective obesity treatment in mice housed under humanized conditions.

Short-term balance training and acute effects on postural sway in balance-deficient older adults: a randomized controlled trial

BackgroundWe aimed to determine the effectiveness of 4 weeks of balance exercise compared with no intervention on objectively measured postural sway.MethodsThis was a single-center parallel randomized controlled, open label, trial. A six-sided dice was used for allocation at a 1:1-ratio between exercise and control. The trial was performed at a university hospital clinic in Sweden and recruited community-dwelling older adults with documented postural instability. The intervention consisted of progressively challenging balance exercise three times per week, during 4 weeks, with follow-up at week five. Main outcome measures were objective postural sway length during eyes open and eyes closed conditions.ResultsSixty-five participants aged 70 years (balance exercise n = 32; no intervention n = 33) were randomized. 14 participants were excluded from analysis because of early dropout before follow-up at week five, leaving 51 (n = 22; n = 29) participants for analysis. No significant differences were detected between the groups in any of the postural sway outcomes. Within-group analyses showed significant improvements in hand grip strength for the intervention group, while Timed Up & Go improvements were comparable between groups but only statistically significant in the control group.ConclusionsPerforming balance exercise over a four-week intervention period did not acutely improve postural sway in balance-deficient older adults. The lower limit in duration and frequency to achieve positive effects remains unclear.Trial registrationClinical trials NCT03227666, July 24, 2017, retrospectively registered.

The Effects of Green Kiwifruit Ingestion on Digestive Health, Blood Flow, Skin Health, and the Autonomic Nervous System

We aimed to assess the impact of consuming two Zespri Hayward green kiwifruit a day on 11 healthy women subjects over a period of 4 consecutive weeks. We analyzed the effects of kiwifruit consumption on intestinal, abdominal, and bowel movement related discomfort, bowel movement frequency, peripheral blood flow, skin health, and autonomic nervous system activity. This study was a randomized control trial, consisting of a four-week intervention period. Participants were divided to ensure equal age distributions and then randomly placed into two intervention groups: a kiwifruit consumption group (n = 11) and a control group (no kiwifruit consumption) (n = 5). The kiwifruit consumption group was instructed to consume two kiwifruit a day during the 4-week intervention period, while subjects in the control group were instructed not to consume kiwifruit for the duration of the study. Besides a restriction from eating yogurt and other fruits, subjects were requested to eat their meals as per usual. The results of this study showed a significant decrease in intestinal, abdominal, and bowel movement discomfort, and a significant increase in bowel movement frequency, at 4 weeks of kiwifruit consumption compared to before consumption. In addition, subjects in the kiwifruit consumption group experienced a significant increase in blood flow, particularly in the index and middle finger at 2 and 4 weeks of kiwifruit consumption. Furthermore, subjects in the kiwifruit consumption group experienced a significant increase in skin brightness at 4 weeks of kiwifruit consumption compared to before consumption. The results of this study suggest that kiwifruit appears to be a delicious and safe option for intestinal, abdominal, and bowel movement discomfort interventions for healthy women. In addition, kiwifruit may aid in increasing bowel movement frequency, peripheral blood flow, and brightness of skin among healthy women as well.

Evaluating the feasibility and effectiveness of self-monitoring of health among Samoan women: a randomized trial

Objective: Self-monitoring technologies that help individuals track their health have proven effective in high-income countries but have not been widely tested or marketed in the Pacific islands. We conducted a pilot randomized controlled trial in Samoa to investigate the feasibility and acceptability of step-counters and digital scales.&#x0D; Methods: The trial enrolled 44 Samoan women (31-40 years), without previously diagnosed chronic conditions (hypertension, diabetes, etc.), who reported motivation to become more physically active. After measuring daily step counts for one week in the absence of feedback, participants were randomly assigned to one of three groups for a four-week intervention period: 1) FitBit Zip® step-counter, 2) digital BodyTrace© scale, or 3) both devices. Outcomes of interest were device use, psychosocial indicators of health, daily step counts, and body mass index, measured at baseline and post-intervention.&#x0D; Results: Participants who received scales used them a median of 5.5 times during the four-week intervention period. While FitBits were used a majority of days during the baseline period, there was significant decline in use during the intervention. In all groups, Health Locus of Control, Self-Efficacy for Exercise, and Weight Efficacy improved. However, while the Scale Only group reported improved health-related quality of life, the two groups that used FitBits either did not significantly change or significantly decreased in their assessments of this measure. No group demonstrated change in average daily step counts during the intervention; BMI increased among the two groups using the scales.&#x0D; Conclusions: Results suggest that self-monitoring technologies are acceptable in Samoa and generally improve psychosocial indicators of health. Further research is necessary to assess their effectiveness as an intervention tool and to determine how best to sustain device use over time. The significant increase in BMI over the relatively short intervention period highlights the importance of developing effective intervention approaches in this setting.

Dorsolateral Prefrontal Cortex Activity during a Brain Training Game Predicts Cognitive Improvements after Four Weeks' Brain Training Game Intervention: Evidence from a Randomized Controlled Trial.

Background: Recent studies have demonstrated that brain activities using NIRS (near-infrared spectroscopy) at baseline during cognitive tasks (e.g., N-back task) can predict the cognitive benefits of a cognitive training. In this study, we investigated whether brain activities during brain training game (BT) at baseline would predict benefits to cognitive functions after the intervention period. Methods: In a four-week double-blinded randomized control trial (RCT) 72 young adults were randomly assigned to one of the two groups: participants in the BT group played specific game, called the Brain Age. Participants in an active control group (ACT) played the puzzle game Tetris. We measured brain activity during the training games using two channel NIRS before the intervention period. Cognitive functions were tested before and after the four-week intervention period. Results: The BT showed significant improvements in inhibition, processing speed, and working memory performance compared to ACT. The left and right DLPFC (dorsolateral prefrontal cortex) brain activities during the BT at baseline were associated with improvements in inhibition and processing speed. Discussion: This randomized control trial first provides scientific evidence that DLPFC activities during BT at baseline can predict cognitive improvements after a four-week intervention period.