Increase In Functional Capacity Research Articles

Epidemic preparedness and response capacity against infectious disease outbreaks in 186 countries, 2018–2022

ObjectivesDisruptive public health risks and events, including infectious disease outbreaks, are inevitable, but their effects can be mitigated by investing in prevention and preparedness. We assessed the epidemic preparedness and response capacities of health systems in 186 countries from 2018 to 2022.MethodsWe utilized data from the International Health Regulations (IHR) State Party Self-Assessment Annual Reporting (SPAR) submissions to assess health systems’ IHR capacities to (1) prevent, (2) detect, (3) respond, (4) enable resources and coordinate, and (5) ensure operational readiness from 2018 to 2022. We categorized the IHR capacities into five levels, with level 1 denoting the lowest level of national capacity and level 5 the highest. We calculated each index’s capacity level as the arithmetic mean of its related indicators and analyzed changes over time using the Mann–Kendall nonparametric trend test.ResultsSPAR reporting marginally improved from 92.9% (182 of 196 countries) in 2018 to 94.9% (186 of 196 countries) in 2022, with considerable improvement in all five capacity domains over this period: prevention (58.4 in 2018 to 66.5 in 2022), detection (74.7 to 78.3), response (56.5 to 67.8), enabling resources and coordination (63.0 to 68.3), and ensuring operational readiness (62.8 to 69.9). From the 2022 submissions, 116 (62%) countries reported functional (Level 4 or 5) prevention capacity, 162 (87%) had functional detection capacity, 118 (63%) had functional response capacity, 121 (65%) had functional enabling resources and coordination capacity, and 133 (72%) had functional operational readiness against public health events. Across all the indexes, the WHO African Region reported the fewest countries with functional capacity in these domains.ConclusionsThere was an overall increase in functional capacity across all five domains at both global and regional levels; and a high percentage of countries achieved functional capacity across all domains in 2022. However, a significant number of countries, particularly in the Global South, have yet to achieve functional competence in these capacities, leaving the world vulnerable to the persistent risk of epidemics and infectious biohazards. Strengthening IHR competencies through local, national, and global engagements must be urgently prioritized to achieve global health security against infectious diseases.

Effectiveness of RF ablation and cementoplasty in enhancing functional capacity in pelvic malignant bone metastases.

Pelvic and sacral bone metastases cause significant morbidity. The primary aim of the study is to thoroughly evaluate the increase in functional capacity resulting from combined RF ablation and cementoplasty surgery applied to malignant bone metastases of the pelvic bones. Twenty patients who underwent RF ablation and cementoplasty for malign pelvic bone and sacrum metastases between January 2014 and December 2021 were retrospectively identified. The inclusion criteria were having a life expectancy of more than 1month, being > 18years old, and having at least 1 month of follow-up. The Visual Anlogue Scale (VAS) pain, Karnofsky Performance Status (KP), and Musculoskelatal Tumor Society (MSTS) scores were calculated. VAS pain values decreased, and KP values increased postoperatively (p = 0.006 and p = 0,013). There was no statistically significant increase in MSTS (p > 0.05). The correlation relationships between lesion filling ratio and VAS pain, KP, and MSTS scores were not statistically significant (p > 0.05). Cement leakage was observed in 5 patients (25.0%), and no symptoms related to this leakage were observed. The pelvic region, given its close proximity to blood vessels, nerves, and joint areas, along with the distinct challenges associated with its surgery, requires separate evaluation. In studies evaluating applications in the isolated pelvic ring region, as in our study, functional gains have been most comprehensively assessed in this study, demonstrating that the procedure results in significant functional improvements.

The Behavior of Maximal Respiratory Pressures, Peak Expiratory Flow and Functional Capacity Between Pilates Method Practitioners

Introduction: The Pilates method is a strategy with positive effects not only on the balance and quality of life of its practitioners, but also on respiratory muscle strength and functional capacity. The aim of this study was to assess respiratory muscle strength and functional capacity among individuals practicing the Pilates method and compare them with the values predicted for the Brazilian population. Methods: This is a cross-sectional, observational study carried out among Pilates practitioners (N=30) of both genders, aged between 20 and 66 years, with at least 4 weeks of practice in the modality under study. Measures of lung function (peak expiratory flow) and strength (maximum respiratory pressures) were analyzed, as well as functional capacity using the step test, which were compared with normal values for the study population. The significance level adopted was p < 0.05. Results: the mean maximum respiratory pressures obtained were lower than those predicted for the Brazilian population. On the other hand, the average number of ascents obtained in the 6-minute step test was significantly higher than the predicted average. No statistically significant difference was found for PEF (p=0.687). Conclusion: The Pilates method did not influence the maintenance of maximum respiratory pressures or PEF measurements in its practitioners. On the other hand, this modern form of physical activity promoted an effective increase in functional capacity, as measured by the step test.

The impact of goal-directed prehabilitation therapy on functional capacity in patients undergoing hepatobiliary and pancreatic surgery: A randomized clinical trial

BackgroundEmerging evidence has supported the idea that goal-directed prehabilitation is a promising approach to boost functional capacity in preoperative patients. However, its usefulness has not been tested in the hepatobiliary and pancreatic fields. The objective of this trial was to investigate the efficacy of goal-directed prehabilitation for improving functional capacity in patients who were planned to undergo major hepatobiliary and pancreatic operations. MethodsThis assessor-blinded, parallel-arm, randomized clinical trial recruited patients who were scheduled for major hepatobiliary and pancreatic surgeries for malignancy. Patients were randomly allocated into the step goal-directed prehabilitation group as the test group and into the conventional prehabilitation group as the control group. Patients in the goal-directed prehabilitation group participated in a walking prehabilitation program with an intergrading goal of the step count. Patients in the conventional prehabilitation group received standard physical and nutritional prehabilitation. The primary outcome was change in the 6-minute walking distance, which ranged from the time before starting prehabilitation (baseline) to the time after completing prehabilitation (immediately before surgery). ResultsAmong 180 randomized patients, 144 patients were included in the primary analysis (73 patients in the conventional prehabilitation group and 71 patients in the goal-directed prehabilitation group). The mean change in the 6-minute walking distance was 27 meters in the conventional prehabilitation group and 31 meters in the goal-directed prehabilitation group (P = .633). ConclusionIn patients undergoing major hepatobiliary and pancreatic surgeries for malignancies, a goal-directed prehabilitation program did not result in a significantly greater increase in functional capacity than did conventional prehabilitation. Registration number: UMIN000038791 (https://www.umin.ac.jp/).

THE PHYSICAL AND MENTAL HEALTH BENEFITS OF PARTICIPATING IN A LUNGS IN ACTION COMMUNITY EXERCISE MAINTENANCE PROGRAM FOLLOWING REHABILITATION

INTRODUCTION AND AIM Lungs in Action (LIA), a signature program of Lung Foundation Australia (LFA) is a community exercise program for people with chronic lung and cardiac conditions. Facilitated by Exercise Physiologists, Physiotherapists and Fitness Instructors, LIA supports patients to maintain the benefits achieved in pulmonary or cardiac rehabilitation. This research aimed to determine the holistic health benefits of participation in LIA through a national participant evaluation, concurrently with functional outcome measures over a 3-month period. METHODS A convenience sample of LIA participants completed an online health questionnaire (Qualtrics) that incorporated the EQ-5D-5L Health Questionnaire, demographics and structured health and wellbeing questions at baseline. A follow-up health questionnaire was undertaken 3-months post baseline. Concurrently, LIA Instructors conducted functional assessments of muscular strength (30sec Sit to Stand (30STS)), mobility, and balance (Timed Up and Go (TUG)) at baseline and 3-months post, to assess if physiological adaptations were evident. RESULTS 108 LIA participants (60±8 years; F=72) consented to complete the baseline questionnaire with n=61 (60±7 years; F=41) completing the 3-month post questionnaire. There were significant improvements in EQ-5D-5L anxiety domain (MD±SD; 0.18±0.22; p=0.04) and overall health rating (EQ-VAS) (MD±SD; 5.62±2.72; p=0.02). 74 participants (60±7 years; F=52) who attended an average of 11±6 classes over the 3-month interval, completed functional testing at both timepoints. There was a significant decrease in time to complete the TUG (MD±SD; -0.81±1.41 sec; p<0.0001) and increase in repetitions for the 30sSTS (MD±SD; 1.68±2.76 reps; p<0.0001). CONCLUSION Results indicate an increase in functional capacity, overall health, and a decrease in anxiety over the 3-month period. These benefits may relate to improved independence and activities of daily living.

Inspiratory Muscle Training in Patients Living With Chronic Kidney Disease and Receiving Hemodialysis: Meta-Analysis of Randomized Controlled Trials.

People living with chronic kidney disease (CKD) and receiving hemodialysis (HD) have impaired respiratory muscle strength and endurance. The objective of this study was to systematically review the effects of inspiratory muscle training (IMT) on respiratory muscle strength, functional capacity, lung function, quality of life, endothelial function, and oxidative stress in people living with CKD and receiving HD. An electronic search was conducted from inception to June 2023. Randomized controlled trials that evaluated the effects of IMT on respiratory muscle strength, functional capacity, lung function, endothelial function, quality of life, or oxidative stress in adults living with CKD and receiving HD, compared with control, placebo IMT, or conventional physical therapy, were included. Eight studies were included, totaling 246 people. The meta-analysis showed that IMT increased the maximum inspiratory pressure (MIP) by 22.53cm H2O, the maximum expiratory pressure (MEP) by 19.54cm H2O, and the distance covered in the 6-minute walk test by 77.63m. Changes in lung function and quality of life were not observed. It was not possible to quantitatively analyze data on endothelial function and oxidative stress. IMT improves MIP, MEP, and functional capacity in people living with CKD and receiving HD. IMT did not demonstrate significant results for lung function and quality of life. Effects on endothelial function and oxidative capacity remain uncertain. Inspiratory muscle training improves MIP, MEP, and functional capacity in people living with CKD and receiving HD, compared with conventional physical therapy or controls or placebo intervention. Increases in functional capacity in this population are extremely important because of the relationship with the survival of these people.

Concurrent Resistance and Cardiorespiratory Training in Patients with Hypertrophic Cardiomyopathy: A Pilot Study.

Background: Exercise training in patients with HCM has evidenced benefits on functional capacity, cardiac function, and a reversion of adverse cardiac remodeling. The objective of this study was to assess the effect of a concurrent resistance and cardiorespiratory training program on functional capacity, biochemical parameters, and echocardiographic variables in a pilot group. Methods: Two HCM patients were evaluated before and after 12 weeks of individualized concurrent training with two sessions/week. Pre- and post-training data were compared for each patient. Evaluations included a cardiopulmonary exercise test (CPET), body composition, echocardiography, electrocardiography, and blood analysis. Results: Training promoted an increase in functional capacity (+4 mL·kg-1·min-1), ventilatory thresholds, and other CPET-derived variables associated with a better prognosis and long-term survival. Muscular mass was augmented (0.8 and 1.2 kg), along with a mean increase of 62% in upper and lower body strength. Echocardiographic features demonstrated the maintenance of cardiac function with signs of positive left ventricular remodeling and an improvement in diastolic function. Blood analyses, including cardiac troponins and NT-proBNP, displayed uneven changes in each patient, but the values fell into normal ranges in both cases. Conclusions: The available data suggest a positive effect of concurrent resistance and cardiorespiratory training on patients' functional capacity and cardiac function that may improve their functional class, quality of life, and long-term prognosis. The replication of this protocol in a larger cohort of patients is warranted to confirm these preliminary results.

Antibiotic alters host's gut microbiota, fertility, and antimicrobial peptide gene expression vis-à-vis ampicillin treatment on model organism Drosophila melanogaster.

Antibiotics are commonly used to treat infectious diseases; however, persistence is often expressed by the pathogenic bacteria and their long-term relative effect on the host have been neglected. The present study investigated the impact of antibiotics in gut microbiota (GM) and metabolism of host. The effect of ampicillin antibiotics on GM of Drosophila melanogaster was analyzed through deep sequencing of 16S rRNA amplicon gene. The dominant phyla consisted of Proteobacteria, Bacteroidetes, Firmicutes, Actinobacteria, Planctomycetes, Chloroflexi, Euryarchaeota, Acedobacteria, Verrucomicrobia, and Cyanobacteria. It was found that the composition of GM was significantly altered on administration of antibiotics. On antibiotic treatments, there were decline in relative abundance of Proteobacteria and Firmicutes, while there were increase in relative abundance of Chlorophyta and Bacteroidota. High abundance of 14 genera, viz., Wolbachia, Lactobacillus, Bacillus, Pseudomonas, Thiolamprovum, Pseudoalteromonas, Vibrio, Romboutsia, Staphylococcus, Alteromonas, Clostridium, Lysinibacillus, Litoricola, and Cellulophaga were significant (p ≤ 0.05) upon antibiotic treatment. Particularly, the abundance of Acetobacter was significantly (p ≤ 0.05) declined but increased for Wolbachia. Further, a significant (p ≤ 0.05) increase in Wolbachia endosymbiont of D. melanogaster, Wolbachia endosymbiont of Curculio okumai, and Wolbachia pipientis and a decrease in the Acinetobacter sp. were observed. We observed an increase in functional capacity for biosynthesis of certain nucleotides and the enzyme activities. Further, the decrease in antimicrobial peptide production in the treated group and potential effects on the host's defense mechanisms were observed. This study helps shed light on an often-overlooked dimension, namely the persistence of antibiotics' effects on the host.

Multimodal Prehabilitation for Patients Undergoing Endovascular Aortic Aneurysm Repair Surgery: A Feasibility Study.

Elective treatment options for aortic abdominal aneurysms include open repair or the less-invasive endovascular aortic aneurysm repair (EVAR). Recovery from EVAR is generally considered easier and faster than open repair. Despite this, EVAR remains a major procedure, and average return to preoperative quality of life is at least 3 months. The purpose of this study is to determine the safety and feasibility of multimodal prehabilitation, a multidisciplinary preoperative optimization intervention, in patients undergoing EVAR and its impact on perioperative functional capacity and quality of life. Candidates for EVAR with an infra-renal abdominal aortic aneurysm <7.5cm were invited to participate in a 6-week multimodal prehabilitation program that included (1) supervised and home-based exercise, (2) nutritional support, (3) psychosocial support, and (4) smoking cessation. Functional capacity and quality of life were assessed at baseline, before surgery and 6 weeks postoperatively. Recruitment rate, safety, and compliance were also assessed. A total of 24 patients were included, 17 males (70%) and 7 females (30%). No adverse events occurred during the program. Compliance to each component of the program (median [Q1-Q3]) was 66% [67] for supervised training, 100% [67] for home-based training, and 100% [100] for nutrition. The multimodal prehabilitation program elicited a significant increase in functional capacity and quality of life preoperatively. Multimodal prehabilitation for patients awaiting EVAR is feasible and safe. Multimodal prehabilitation improves both functional capacity and quality of life preoperatively. Further research is needed to assess the impact of multimodal prehabilitation on postoperative quality of life and functional capacity. Multimodal prehabilitation is safe and feasible in patients awaiting endovascular aneurysm repair. The importance of this finding is that multimodal prehabilitation can be safely delivered preoperatively in patients awaiting EVAR. Although further research is needed, multimodal prehabilitation seems to improve preoperative functional capacity and quality of life. This could have an impact for the future implementation of prehabilitation interventions in order to increase functional reserve and quality of life preoperatively so that this high-risk population can cope better with the surgical stress and return to their normal life faster postoperatively.

Effect of yoga-based exercises on functional capacity, dyspnea, quality of life, depression, anxiety, and sleep of infected healthcare workers during the COVID-19 pandemic: A prospective clinical trial.

The study aimed to investigate the effect of yoga-based exercises on functional capacity, dyspnea, quality of life, depression, anxiety, and sleep quality following coronavirus disease 2019 (COVID-19). Forty-one COVID-19-infected healthcare professionals (35 females, 6 males; mean age: 39.7±6.5 years; range, 28 to 55 years) who were actively working during the subacute period were included in the prospective controlled study between March 2021 and September 2021. The participants were divided into two groups: the yoga-based exercise group (YBEG; n=26) and the nonintervention group (n=15). Besides routine recommendations, the YBEG performed stretching, relaxation, isometric strengthening, breathing, and meditation exercises of 60 min twice a week for eight weeks. Clinical outcome was measured with flexibility tests (shoulder flexibility and sit and reach tests), hand grip strength, 6-min walk test, dyspnea score, Beck Depression and Anxiety Inventory, Short Form 36 (SF-36) quality of life, Pittsburgh sleep quality index (PSQI), and the International Physical Activity Questionnaire (IPAQ) before and after eight weeks in both groups. Beck anxiety scores, IPAQ scores, PSQI, SF-36 pain, and social functioning subparameters were positively statistically significant in the YBEG (p<0.05). The only parameter found to be insignificant in time and between groups was the SF-36 mental health subparameter (p>0.05). In addition, the YBEG had significant improvements in muscle strength, flexibility, functional capacity, physical activity level, quality of life, anxiety, depression levels, and sleep scores between before and after the eight-week intervention period (p<0.05). Yoga programs have led to an increase in functional capacity and physical performance, a decrease in anxiety and depression complaints, and an increase in the quality of life in healthcare professionals who were in the process of returning to work during the post-COVID-19.

Physical function and severe side effects matter most to patients with RA (< 5 years): a discrete choice experiment assessing preferences for personalized RA treatment

AimEarly assessment of patient preferences has the potential to support shared decisions in personalized precision medicine for patients with rheumatoid arthritis (RA). The aim of this study was to assess treatment preferences of patients with RA (< 5 years) with previous experience of inadequate response to first-line monotherapy.MethodPatients were recruited (March–June 2021) via four clinics in Sweden. Potential respondents (N = 933) received an invitation to answer a digital survey. The survey included an introductory part, a discrete choice experiment (DCE) and demographic questions. Each respondent answered 11 hypothetical choice questions as part of the DCE. Patient preferences and preference heterogeneity were estimated using random parameter logit models and latent class analysis models.ResultsPatients (n = 182) assessed the most important treatment attributes out of physical functional capacity, psychosocial functional capacity, frequency of mild side effects and likelihood of severe side effects. In general, patients preferred a greater increase in functional capacity and decreased side effects. However, a substantial preference heterogeneity was identified with two underlying preference patterns. The most important attribute in the first pattern was the ‘likelihood of getting a severe side effect’. Physical functional capacity was the most important attribute in the second pattern.ConclusionRespondents focused their decision-making mainly on increasing their physical functional capacity or decreasing the likelihood of getting a severe side effect. These results are highly relevant from a clinical perspective to strengthen communication in shared decision making by assessing patients’ individual preferences for benefits and risks in treatment discussions.

Patient education and rehabilitation after pulmonary thromboembolism

Persistent or worsening of dyspnea and limitation of physical activities in patients after an episode of acute pulmonary thromboembolism, reported in long-term studies, may subsequently be the main determinant of impaired quality of life. Physical rehabilitation and patient education after a thromboembolic event has not taken its place in the management of this group of patients. We set out to implement of patient education and the partially supervised physical rehabilitation program at home for patients after PE in the first 3 months after the acute event. The results of our study demonstrated the increase in functional capacity, the improvement of the quality of life, the reduction of the symptom of dyspnea. This article is part of the results of the study within the state project with the figure 20.80009.8007.28.

Safety and feasibility of a randomized controlled trial testing a personalized exercise program in patients with cancer: The CHOiCE trial.

e24045 Background: Growing evidence suggests that physical exercise (EX) may reduce mortality and recurrence risk in patients (pts) with cancer, as well as help in managing cancer treatment side effects and improve quality of life (QoL). Despite these well-recognized benefits, most pts are insufficiently active, and compliance with the EX intervention is often challenging. This pilot study aimed to evaluate the safety, feasibility, and preliminary efficacy of a 3-month EX-intervention in pts with cancer. Methods: A pilot, two-center randomized controlled trial was conducted on pts with different cancers at early stages. Pts allocated in the 3-month EX intervention participated in bi-weekly aerobic and resistance training tailored to the patient's baseline condition and preferences. The duration of aerobic training progressively increased over weeks, whereas the resistance component consisted of body weight or elastic-bands exercises performed in 2-3 sets of 8-12 repetitions. EX intensity was moderate and monitored using the 10-point Borg Rating of the Perceived Exertion Scale. Pts randomized to control received usual care. Primary study endpoints were safety, monitored through the Common Terminology Criteria for Adverse Events (AEs), and feasibility, evaluated through recruitment rate, adherence, and withdrawals. Secondary endpoints included functional capacity, using the Six minutes walking test, and muscle strength, with the handgrip and leg press test. European Organization for Research and Treatment of Cancer Quality of Life and Core Questionnaire (EORTC- QLQ-C30) was used to assess the QoL. Descriptive statistics was applied, and repeated-measures analysis of variance was used to evaluate within- and between-group differences. Results: With a 38% recruitment rate, 57 pts were randomized (56 years; 68% breast, 14% colorectal) to the EX-intervention (n = 37) and controls (n = 20). Five dropouts occurred, n = 3 in the EX-group (leukemia onset n = 1, psychiatric disorder n = 1, gonarthrosis n = 1), and n = 2 in the controls (lack of interest n = 2). Adherence to EX-sessions was high, 93%. Concerning safety, three AEs were reported: worsening in the lymphedema, Grade 1 (n = 2), and elbow inflammation, Grade 1. Compared to the controls, EX-group reported a significant increase in functional capacity (within group, p &lt; 0.01), and lower limb strength (within and between group, p &lt; 0.01). Regarding QoL, EX produced enhancements in social function (within group, p &lt; 0.05), fatigue (within group, p &lt; 0.05), nausea and vomiting (within group p &lt; 0.01), dyspnea (within group, p &lt; 0.05), insomnia (within group, p &lt; 0.05), and loss of appetite (within group, p &lt; 0.01). Conclusions: Preliminary findings support the feasibility of a combined aerobic and resistance EX in pts with cancer with minimal AEs. Moreover, improvements in physical parameters and some domains of QoL were detected. Clinical trial information: NCT04226508 .

Spirituality, Functional Gain, and Quality of Life in Cardiovascular Rehabilitation.

Religiosity and spirituality have been associated with higher recovery rates, greater adherence to treatments, and better levels of quality of life in patients with heart disease. To evaluate the association between spirituality, functional gain, and improved quality of life in patients in a cardiovascular rehabilitation program. This prospective cohort study evaluated the association between functional and quality of life gains during a cardiovascular rehabilitation program and a religiosity/spirituality index based on a validated scale. Depression, anxiety, and stress symptoms were screened for control purposes. P values < 0.05 were considered significant for all analyses. The study followed 57 patients (66 ± 12 years old; 71.7% male; 76% with coronary artery disease). The Spearman correlation coefficient did not show any associations between increases in functional capacity and organizational (rs = 0.110; p = 0.421), non-organizational (rs = -0.007; p = 0.421), or intrinsic (rs = -0.083; p = 0.543) religiosity. Furthermore, no associations were detected between the results of a quality of life score and organizational (rs = 0.22; p = 0.871), non-organizational (rs = 0.191; p = 0.159), or intrinsic (rs = 0.108; p = 0.429) religiosity. No association was detected between functional and quality of life gains and organizational, non-organizational, or intrinsic religiosity in this sample of patients undergoing cardiovascular rehabilitation.

The Effect of Aaerobic Exercise on Functional Capacity Increase in Coronary Heart Disease Patients: A Narrative Review

The heart condition known as coronary heart disease (CHD) is brought on by the narrowing of the coronary arteries as a result of atherosclerosis, spasm, or a combination of both. This results in a disruption in the supply of oxygen and nutrients to the myocardial tissue due to a decrease in coronary blood flow and a reduction in functional capacity. Objective: The study aims to determine the effect of aerobic exercise on functional capacity increase in coronary heart disease patients. Method: The research employed a narrative review method with the PICO framework (Population/Patient/Problem, Intervention, Comparation, and Outcome). The journals were searched from 2 databases, namely Google Scholar with 15,700 articles and Pubmed 639 articles. The inclusion criteria in this study were national or international articles and full text about the effect of aerobic exercise on functional capacity decline in coronary heart patients published in 2012- 2022. Result: After reviewing the title, relevancy of the abstract, and full text of 16,334 papers from 2 databases, 10 journals demonstrated that aerobic exercise was effective to increase the functional capacity in coronary heart disease patients. Conclusion: There is an effect of aerobic exercise on functional capacity increase in coronary heart disease patients.Keywords: Aerobic Exercise, Coronary Heart Disease, Functional Capacity

Regional differences regarding the occurrence of falls and associated factors in two populations of Brazilian longevous people

BackgroundFew studies have explored regional asymmetries and their implications for health policies regarding episodes of falls among the population of ≥80 years old in continental and developing countries like Brazil with deep inequalities and sociocultural differences.ObjectiveTo evaluate the occurrence of falls and their association with functional capacity and nutritional status in the longest oldest-old living in two municipalities in the Northeast and Southeast of Brazil.MethodsThis is a cross-sectional study, with primary data collection in which were included in the research seniors aged 80 years or more, of both sexes, belonging to two Brazilian municipalities of discrepant socioeconomic aspects. The dependent variable was the occurrence of falls in the last year. The independent variables were grouped into demographic aspects, functional capacity and nutritional status. To identify variables that contribute to the occurrence of falls, the multiple logistic regression model, adopts a significance level of 5%.ResultsThe sample was composed of 415 oldest-old adults. From the total, 32.3% reported having fallen in the last year, 24.7% in Brejo dos Santos and 37.8% in São Paulo. Among the former population, the mean value of walking speed for those who had falls was 0.27 m/s and for those who had no occurrence of falls was 0.33 m/s; and, among the seniors from São Paulo, the mean values were 0.51 m/s and 0.58 m/s, respectively. Significant correlations between walking speed and falls were verified for both populations, showing that the lower the walking speed, the higher the predisposition to falls. In the final regression model, the occurrence of falls was associated with moderate balance (OR = 5.28; CI: 1.11–25.18) among the longevous people Brejo dos Santos and with very poor functional performance (OR = 16.09; CI:1.46–177.06) among those from São Paulo.ConclusionThe results pointed out a lower prevalence of falls in longevous people from Brejo dos Santos than in those from São Paulo and differences regarding the associated factors, showing heterogeneity between the two populations; indicating the need for public policies and effective programmes aimed at preventing falls based on the maintenance or increase of functional capacity.

Supervised high-load resistance training for improving muscle strength and quality in prediabetic older adults: A pilot randomized controlled trial

ObjectiveTo investigate the effects of high- and low-load supervised, volume-matched resistance training (RT) on body composition, muscle function, and functional capacity in older adults with prediabetes. MethodsOlder adults with prediabetes were recruited and randomly assigned to high-load RT (n = 13), low-load RT (n = 12), or control groups (n = 12). ResultsNo significant differences were observed in body composition at postintervention. High-load and low-load RT groups exhibited significant improvements in functional tests at postintervention compared with the control group. The high-load RT group exhibited a greater improvement in muscle strength and muscle quality at postintervention compared with the low-load RT group. ConclusionSupervised RT is useful in the prevention of muscle functional loss in older adults with prediabetes. High-load RT is superior for enhancing muscle strength and muscle quality, despite a similar increase in functional capacity.

Dynamics of microbial communities during biotransformation of nitrofurantoin

The purpose of this research was to investigate the biodegradation of nitrofurantoin (NFT), a typical nitrofuran antibiotic of potential carcinogenic properties, by two microbial communities derived from distinct environmental niches – mountain stream (NW) and seaport water (SS). The collected environmental samples represent the reserve of the protected area with no human intervention and the contaminated area that concentrates intense human activities. The structure, composition, and diversity of the communities were analyzed at three timepoints during NFT biodegradation. Comamonadaceae (43.2%) and Pseudomonadaceae (19.6%) were the most abundant families in the initial NW sample. The top families in the initial SS sample included Aeromonadaceae (31.4%) and Vibrionaceae (25.3%). The proportion of the most abundant families in both consortia was remarkably reduced in all samples treated with NFT. The biodiversity significantly increased in both consortia treated with NFT suggesting that NFT significantly alters community structure in the aquatic systems. In this study, NFT removal efficiency and transformation products were also studied. The biodegradation rate decreased with the increasing initial NFT concentration. Biodegradation followed similar pathways for both consortia and led to the formation of transformation products: 1-aminohydantoin, semicarbazide (SEM), and hydrazine (HYD). SEM and HYD were detected for the first time as NFT biotransformation products. This study demonstrates that the structure of the microbial community may be directly correlated with the presence of NFT. Enchanced biodiversity of the microbial community does not have to be correlated with increase in functional capacity, such as the ability to biodegradation because higher biodiversity corresponded to lower biodegradation. Our findings provide new insights into the effect of NFT contamination on aquatic microbiomes. The study also increases our understanding of the environmental impact of nitrofuran residues and their biodegradation.

191. THE IMPACT OF PREHABILITATION IN UPPER GASTROINTESTINAL (GI) CANCER UNDERWENT SURGERY

Abstract Major upper gastrointestinal (GI) surgery always poses unique perioperative challenges and high post-surgical complications. Prehabilitation encompasses of exercise, nutrition and medical optimization prior to surgery. There is an emerging evidence to show prehabilitation plays a significant role in reducing morbidity and mortality associated with major upper GI surgery by improving patient’s functional status. Its role in improving postoperative outcomes such as length of stay (LOS) is less established. An interventional study conducted among oesophageal and gastric cancer patients who undergone oesophagectomy and gastrectomy surgery. All the preoperative patients are assessed by dietician and nutrition therapy will be intiated based on ESPEN guideline. A standard set of physical and breathing exercise are adopted. Study characteristics, ECOG status, handgrip, peak flow meter and spirometry are obtained. Primary outcome is impact of prehabilitation on functional capacity. Secondary outcomes include post-operative length of stay and complications based on Clavien-Dindo classification. Thirty one (31) patients who were recruited [gastrectomy (n = 21) and oesophagectomy (n = 10)]. Mean age was 59.2 ± 8.9 years. 21(67.7%)was male patients. Majority of the participants were SGA B (51.6%) with good ECOG status of 1(61.3%). Most of the diseases were in advanced stage [stage III (54.9%), stage IV (9.7%)].After prehabilitation, handgrip strength, peak flow meter and spirometry were significantly higher before surgery (20.9 vs 26.1, p = 0.002; 322.2 vs 419.3, p = 0.002; 77.4% vs 90.3%, p = 0.007 respectively). No significant difference in LOS and post operative complications were observed. Prehabilitation was associated with significant increase in functional capacity after intervention. Hence prehabilitation should be strongly recommended among patient undergoing major upper GI surgery to accelerate recovery from cancer surgery. However, there is insufficient data to demonstrate its role in improving clinical outcomes, including LOS and post operative complications.

194. THE IMPACT OF PREHABILITATION IN UPPER GASTROINTESTINAL (GI) CANCER UNDERWENT MAJOR SURGERY

Abstract Major upper gastrointestinal (GI) surgery always poses unique perioperative challenges and high post-surgical complications. Prehabilitation encompasses of exercise, nutrition and medical optimization prior to surgery. There is an emerging evidence to show prehabilitation plays a significant role in reducing morbidity and mortality associated with major upper GI surgery by improving patient’s functional status. Its role in improving postoperative outcomes such as length of stay (LOS) is less established. An interventional study conducted among oesophageal and gastric cancer patients who undergone oesophagectomy and gastrectomy surgery. All the preoperative patients are assessed by dietician and nutrition therapy will be intiated based on ESPEN guideline. A standard set of physical and breathing exercise are adopted. Study characteristics, ECOG status, handgrip, peak flow meter and spirometry are obtained. Primary outcome is impact of prehabilitation on functional capacity. Secondary outcomes include post-operative length of stay and complications based on Clavien-Dindo classification. Thirty one (31) patients who were recruited [gastrectomy (n = 21) and oesophagectomy (n = 10)]. Mean age was 59.2 ± 8.9 years. 21(67.7%)was male patients. Majority of the participants were SGA B (51.6%) with good ECOG status of 1(61.3%). Most of the diseases were in advanced stage [stage III (54.9%), stage IV (9.7%)].After prehabilitation, handgrip strength, peak flow meter and spirometry were significantly higher before surgery (20.9 vs 26.1, p = 0.002; 322.2 vs 419.3, p = 0.002; 77.4% vs 90.3%, p = 0.007 respectively). No significant difference in LOS and post operative complications were observed. Prehabilitation was associated with significant increase in functional capacity after intervention. Hence prehabilitation should be strongly recommended among patient undergoing major upper GI surgery to accelerate recovery from cancer surgery. However, there is insufficient data to demonstrate its role in improving clinical outcomes, including LOS and post operative complications.