Multimodal Exercise Research Articles

A Multimodal Exercise Program Does Not Improve Measures Of Cardiometabolic Health In Chronic Spinal Cord Injury

A Multimodal Exercise Program Does Not Improve Measures Of Cardiometabolic Health In Chronic Spinal Cord Injury

Study protocol of a cluster-randomised controlled trial assessing a multimodal machine-based exercise training programme in senior care facilities over 6 months – the bestform study (best function of range of motion)

BackgroundPhysical functioning is a crucial factor for independence and quality of life in old age. The aim of the "bestform—Best function of range of motion" trial is to investigate the effects of a 6 months multimodal machine-based strength, coordination and endurance training on physical function, risk of falls and health parameters in older adults.MethodsBestform is a cluster-randomised trial including older adults ≥ 65 years living in senior care facilities in Southern Germany. Senior care facilities are randomly allocated to the control group with usual care (n ≥ 10 care facilities) and to the intervention group (n ≥ 10 care facilities), overall including ≥ 400 seniors. Residents belonging to the intervention group are offered a supervised machine-based exercise training programme twice weekly over 45–60 min over six months in small groups, while those in the usual care facilities will not receive active intervention. The primary outcome is the change in Short Physical Performance Battery over six months between groups. Secondary outcomes are change in risk of falling, fear of falling, number of falls and fall-related injuries, physical exercise capacity, handgrip strength, body composition, cardiac function, blood parameters, quality of life, risk of sarcopenia, activities of daily living, and cognition over three and six months.DiscussionThe bestform study investigates the change in physical function between seniors performing exercise intervention versus usual care over six months. The results of the study will contribute to the development of effective physical activity concepts in senior care facilities.Trial registrationClinicalTrials.gov: NCT04207307. Registered December 2019.

Acute blood pressure responses of hypertensive patients after multimodal training session: Protocol study

Background: Systemic arterial hypertension (SAH), as well as other chronic degenerative diseases, has been growing around the world. In this context, physical exercise is presented as a non-pharmacological strategy both in the treatment and in the prevention of this disease. Although pressure responses to strength and aerobic exercise are vast in the literature, in high-intensity multimodal exercises they are very scarce. Objectives: To develop a study protocol on the acute effects of blood pressure after a high-intensity multimodal training session in adult hypertensive individuals through a randomized crossover clinical trial. Methods: This is a controlled crossover clinical trial to evaluate the acute responses of blood pressure after a multimodal training session in hypertensive patients. 20 hypertensive adults will be recruited, who, after inclusion in the study, will perform 02 protocols with an interval of 07 days, one session of high-intensity multimodal exercises, and a control session (without exercises). Blood pressure (BP) will be measured before, immediately after, and for 60 minutes after carrying out the protocols. Results: The designed intervention is expected to provide additional information on the behavior of (BP) hypertensive individuals in the practice of multimodal exercises.

Effects of multimodal exercise program on postural balance in patients with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial

BackgroundEvidence has shown that patients with chronic obstructive pulmonary disease present significant deficits in the control of postural balance when compared to healthy subjects. In view of this, it is pertinent to investigate the effects of different therapeutic strategies used alone or in association with pulmonary rehabilitation with the potential to improve postural balance and other outcomes with clinical significance in patients with chronic obstructive pulmonary disease. This study will investigate the effects of an 8-week (short-term) multimodal exercise program [inspiratory muscle training (IMT) plus neuromuscular electrical stimulation (NMES)] on postural balance in patients with chronic obstructive pulmonary disease enrolled in a pulmonary rehabilitation program compared to individualized addition of IMT or NMES to pulmonary rehabilitation or standard pulmonary rehabilitation.MethodsThis is a randomized, single-blind, 4-parallel-group trial. Forty patients with chronic obstructive pulmonary disease will be included prospectively to this study during a pulmonary rehabilitation program. Patients will be randomly assigned to one of four groups: multimodal exercise program (IMT + NMES + pulmonary rehabilitation group) or (IMT + pulmonary rehabilitation group) or (NMES + pulmonary rehabilitation group) or standard pulmonary rehabilitation group. Patients will receive two sessions per week for 8 weeks. The primary outcome will be static postural balance and secondary outcomes will include as follows: static and dynamic postural balance, fear of falling, muscle strength and endurance (peripheral and respiratory), functional capacity, health-related quality of life, muscle architecture (quadriceps femoris and diaphragm), and laboratory biomarkers.DiscussionThis randomized clinical trial will investigate the effects of adding of short-term multimodal exercise program, in addition to pulmonary rehabilitation program, in postural balance in patients with chronic obstructive pulmonary disease enrolled in a pulmonary rehabilitation. Furthermore, this randomized control trial will enable important directions regarding the effectiveness of short-term intervention as part of the need to expand the focus of pulmonary rehabilitation to include balance management in chronic obstructive pulmonary disease patients which will be generated.Trial registrationClinicalTrials.gov NCT04387318. Registered on May 13, 2020.

Effect of a 12-Week High-Calorie-Expenditure Multimodal Exercise Program on Health Indices in Women With Overweight: Protocol for a Randomized Controlled Trial.

High-calorie-expenditure training is common among endurance athletes and is an effective strategy for weight loss. Although many training protocols include walking, running, cycling, and swimming according to a target heart rate, there is limited research on high-calorie-expenditure interventions with multimodal training programs using quantitative methods. The aims of this research protocol are to (1) develop a high-calorie-expenditure training program to cover target calorie expenditure according to the trainability of women classified as overweight (according to a BMI of 25-29.9 kg/m2); (2) determine the effect of high-calorie-expenditure workouts on conditioning, glycemic variables, and body composition; and (3) evaluate the implementation of the intervention and results in comparison with outcomes obtained under a standard-calorie-expenditure training program. This is a randomized controlled trial with a pretest-posttest design. Participants include 33 women with a BMI in the overweight range (25-29.9) allocated to three groups: two intervention groups and one control group. The intervention will be conducted for 12 weeks. Participants in the first group will be assigned an exercise program with high energy expenditure of approximately 3000-3500 kilocalories/week in the form of 5 sessions per week with an intensity of 50%-75% maximum oxygen rate (VO2 max) and 60%-80% target heart rate. The second group will be assigned an exercise program with a standard energy expenditure of approximately 1200-1500 kilocalories/week with 3 sessions per week at an intensity of 60%-75% VO2 max, according to The American College of Sports Medicine guideline. The effects of the multimodal training program with daily tasks will be compared to those of the standard-calorie-expenditure and control (no exercise) conditions with respect to changes in glycemic indices and body composition. Daily calories will be calculated through the International Physical Activity Questionnaire and using Nutrition 4 software. Preliminary results show significant weight loss in both the high- and standard-calorie-expenditure groups (P=.003). Significant improvements were also found in muscle percentage (P=.05) and BMI (P=.05) for the high-calorie-expenditure group. Analyses are ongoing for glycemic indices, inflammation factors, and blood parameters. High-calorie-expenditure training can cause further weight loss than standard exercise, which can eventually lead to greater fat mass reduction and improvement in glycemic indices. These results demonstrate that, in some cases, it may be necessary to increase the activity of women and use multimodal exercise programs with increased volume and intensity to increase the expenditure of exercise and daily activity. We found a net effect of exercise and daily activity at the individual level, whereas the daily lifestyle and physical behaviors of the participants remained constant. Iranian Registry of Clinical Trials IRCT20220202053916N1; https://tinyurl.com/c8jxfw36. DERR1-10.2196/51599.

Sex-Related Differences in Functional Fitness Outcomes in Older Adults.

Sex-related differences in changes in functional fitness over time were longitudinally assessed in older adults participating in a group-based multimodal exercise program. From a database, functional fitness scores were obtained for 89 older adults (71.6 ± 6.5years old) who had completed two assessments, 5-8years apart. Lower body strength, upper body strength, aerobic endurance, flexibility, and change of direction performances were compared over time and with normative values. Females (p = .02), but not males, had an improvement in upper body strength over time. Females were also more flexible than males at both assessments (p ≤ .02). Of those who had five consecutive assessments, females were more flexible than males (p ≤ .05) and had a faster change of direction ability (p < .001). When compared with normative values, our results indicate that typical time-related functional fitness loss can be attenuated with group exercise. Our results further support the need to tailor exercise prescription according to the individual.

Effectiveness of therapeutic exercise for the management of cervicogenic headache: A systematic review

ObjectiveThe main aim of this systematic review is to evaluate the effectiveness of therapeutic exercise for managing pain and disability in patients with cervicogenic headache (CEH). MethodsA protocol for this systematic review was published in PROSPERO (CRD42019122703). PRISMA and AMSTAR2 standards were followed. Based on an extensive systematic search in five databases (EMBASE, MEDLINE, CINHAL, PsychInfo and SportDISCUS) and the CENTRAL trial register, two reviewers carefully and independently assessed, selected results, collected data, rated the risk of bias (RoB) of included studies with the Cochrane risk of bias tool, synthesized the available evidence, and rated it using GRADE methodology. ResultsA total of 12 manuscripts, reporting on 11 studies were included. Most studies showed a high risk of bias (63,63%). Additionally, a great deal of heterogeneity was observed regarding interventions, comparisons, and outcomes and thus, results could not be synthesized in meta-analyses. The quality of the evidence was found to be from low to very low. Significant differences with large effect sizes were found when comparing multimodal exercise vs. control groups on headache outcomes (SMD = 0.73; 95%CI [0.31, 1.14] for headache intensity and SMD = 0.98; 95%CI [0.56, 1.41], for headache frequency). ConclusionsFindings indicate that therapeutic exercise may be effective to achieve clinically relevant reductions in headache intensity and frequency as well as disability for patients suffering from cervicogenic headache. However, more high-quality research is needed to gain confidence in this finding and possibly determine optimal types and dosage of therapeutic exercise.

Nonlinear, Multicomponent Physical Exercise with Heart Rate Variability-Guided Prescription in Women with Breast Cancer during Treatment: Feasibility and Preliminary Results (ATOPE Study).

The purpose of this study was to examine the feasibility, safety, adherence, and preliminary efficacy of the ATOPE program during radiotherapy (RT) or chemotherapy (CT) for women with breast cancer. This single-blind, pretest-posttest feasibility study included 38 women with breast cancer at the beginning of their treatment. The ATOPE program consisted of 12 to 18 sessions of a multimodal physical exercise program, prescribed based on daily heart rate variability (HRV) and clinimetric assessments using the ATOPE+ mHealth system. Overall health was assessed with quality of life, autonomous balance, and body composition, whereas health-related fitness (HRF) was measured through functional capacity, physical activity levels, and upper and lower limb strength. The rates of recruitment, retention, and adherence were 52.35%, 73.68%, and 84.37%, respectively, and the satisfaction rating was 9.2 out of a possible 10 points. The perceived health status change score was 3.83 points, scored on a - 5 to 5 point scale. No adverse effects were found. Compliance results showed that the ATOPE+ mHealth system was used on 73.38% of the days, and the Fitbit bracelet (Google, Mountain View, CA, USA) was used on 84.91% of the days. Women stayed physically active 55% of days. Regarding preliminary results, for overall health, the percentage of body fat in the RT group decreased by 1.93%, whereas it increased by 5.03% in the CT group. Lower limb strength increased in the RT group, specifically knee extensor isometric strength (6.07%), isokinetic knee flexors 180°/s (1.53%) and isokinetic knee extensors 300°/s (4.53%), in contrast with the reductions found in the CT group (11.07%, 18.67%, and 14.89%, respectively). The ATOPE program, through nonlinear prescription based on daily monitoring with the ATOPE+ mHealth system, is feasible and safe for application during breast cancer treatment. The results suggest that overall health can be maintained or even improved regarding most variables. This study focused on the feasibility, safety, and completion of a physical therapist-led program at early diagnosis for adults with breast cancer. The multimodal, supervised, tailored, nonlinear physical exercise program is feasible and safe, showed a good completion rate, and was able to prevent the quality-of-life deficits that are often triggered by systemic breast cancer treatment. This study highlights the importance of daily morning assessments using the ATOPE+ mHealth system in patients with breast cancer to prescribe nonlinear physical exercise.

Leisure mobilities, shopping routes and sensescapes: youth in the city centre of Utrecht

This paper analyses embodied experiences of leisure shoppers combining walking and cycling practices in historical city centres. From the perspective of youth, embodied practices and experiences along the Oude Gracht street, an important shopping route in the city centre of Utrecht, are investigated. Based on walk-along interviews with pedestrians and seated interviews with cyclists, the paper reveals leisure shopping as a multimodal exercise with interrelated practices and experiences of walking and cycling. It also unravels shopping routes as arrangements of various sensescapes. They are described by youth ‘in motion’ and en route along the Oude Gracht as (1) calm and beginning, (2) chaos and vehicles, (3) crowding and many choices, (4) crossing and street sellers, (5) chaos and tourists, and (6) cafes and ending. The fluid divisions and connections of these scapes are accompanied by physical and social objects – such as motorized vehicles, a cinema or shop, a large crowd, and street vendors – often generating a switch in the type of walking and cycling. By looking at youth’s practices and experiences, sensescapes appear to be relational in space and time, exposing the complexity of fluid divisions and connections when performing leisure mobilities along shopping routes in city centres.

Evaluating the impact of exercise in women living with indolent metastatic breast cancer: The EMBody trial.

TPS12140 Background: Exercise is associated with improved survival, physical function, treatment tolerability, and quality of life in early-stage breast cancer. Prospective trials support the positive impact of exercise on cardiorespiratory fitness (CRF), physical function, and muscle mass. These same endpoints matter in metastatic breast cancer (MBC). CRF is a predictor of worse cancer- specific survival, and there is a high prevalence of physical impairment and sarcopenia in patients with MBC, both associated with worse quality of life and survival. Two previous exercise trials in those with MBC have found exercise to be not feasible or of limited benefit. These findings may be due to a heterogeneous participant population that is primarily receiving cytotoxic chemotherapy. Patients with MBC have variable disease trajectories and supportive care needs; those with indolent MBC have longer life expectancy, lower symptom burden and distinct priorities, and are well-positioned to participate in and benefit from an exercise program. The EMBody trial is focused on enrolling a homogeneous patient population with indolent, stable MBC and improving endpoints known to correlate with survival outcomes in this population. Here, we evaluate the impact of a multimodal exercise intervention on CRF, physical function, body composition, and PROs. This study will be a step toward redefining “survivorship” to extend to those living with MBC. Methods: In this prospective phase II trial (NCT05468034), 100 patients with MBC are randomized 1:1 to exercise intervention or wait-list control, stratified by baseline function. Eligible patients have no evidence of disease progression in the prior 12 months and may be receiving endocrine, targeted, immuno-, or antibody drug conjugate therapy. Patients receiving cytotoxic chemotherapy are not eligible as this subgroup did not benefit in prior trials. Target enrollment is 3-4 participants per month over 2.5 years, beginning January 2023. The virtually-delivered exercise intervention arm achieves moderate intensity exercise with oncology-certified exercise physiologists 3 days/week for 16 weeks. The 60-minute sessions include aerobic, resistance, balance and stretching exercises. The exercise arm receives informational sessions on the role of exercise in cancer and principles of habit and self-efficacy. The primary endpoint is 16 week change in CRF on a ramp treadmill test between the exercise and control arms. Secondary endpoints include change in a physical function battery, muscle mass assessed by CT scans, and PROs of fatigue and quality of life. Exploratory analysis includes behavioral modifiers of exercise adherence and effectiveness and serologic measures of inflammatory, metabolic, and immune pathway biomarkers, as well as changes in circulating tumor cells. Patients will be followed post- intervention for sustained behavior change and survival trajectory. Clinical trial information: NCT05468034 .

Multimodal Exercise in Older Patients with Advanced Pancreatic Cancer Undergoing First-Line Chemotherapy: A Case Series Examining Feasibility and Preliminary Efficacy

Purpose. Exercise is emerging as an adjunct therapy to cancer treatment; however, its role in older patients with advanced pancreatic cancer undergoing first-line chemotherapy is unclear. The aim of this study was to primarily provide evidence on feasibility with an exploratory examination of the initial efficacy of exercise in this clinical setting. Materials and Methods. Six patients aged 60–75 years with de novo or recurrent advanced pancreatic cancer undergoing first-line chemotherapy consented to participate in twice-weekly exercise that included resistance and aerobic training and boxing-related activities for up to 12 weeks. Patients were monitored for attendance, adherence, and adverse events. Body composition, muscle strength, functional ability, patient-reported outcome measures, and patient-reported experience measures were assessed at baseline and/or postintervention. Results. Of the 6 patients, 1 withdrew after baseline testing and 5 attended 42%–95% of planned sessions and adhered to 28%–83% of the prescribed exercise. There were no serious exercise-emergent adverse events. All 5 patients increased or maintained lean mass (0.1%–4.4%) and 4 reduced fat mass (−0.4%–−8.6%). Improvements were observed in 4 or all 5 patients for muscle strength (7.1%–75%), 5 times sit-to-stand (1.3%–21.4%), 6-m backward walk (16.5%–35.8%), and patient-reported outcomes. Furthermore, all patients perceived exercise as very helpful in managing their cancer and expressed a strong willingness to continue exercise in the future. Conclusion. A multimodal exercise program appears feasible with potential physical and psychological benefits for older patients with advanced pancreatic cancer undergoing first-line chemotherapy. Further research including a larger sample size is warranted.

Physical activity interventions in older adults with a cognitive impairment: A critical review of reviews.

This critical review explores the review material on physical activity combined with cognitive stimulation interventions in older adults with cognitive impairment and/or dementia. A critical, systematic, review of the review method was used, considering four electronic databases: WEB OF SCIENCE, SCOPUS, MEDLINE, and the COCHRANE ELECTRONIC LIBRARY. The search terms "exercise," "physical activity," "cognitive impairment," "dementia," and "systematic review" were used. All available reviews were marked against predetermined inclusion and exclusion criteria. There were 32 reviews that met the inclusion criteria. A combination of various types of training and aerobic exercises were the most frequently reported interventions; meanwhile, dual task training programs (combining physical exercise with cognitive stimulation), functional training programs along with exercises combination, aerobic exercise as well as strength, stretching, or balance workouts were also reported. The evidence is compelling; exercise can improve physical health by ensuring cognitive, psychological, and behavioral benefits. Overall, exercise can improve the physical and mental health of people living with dementia: there is sufficient evidence to recommend multimodal exercise.

Effects of Multimodal Exercise on Health-related Physical Fitness and Quality of Life in Patients with Nasopharyngeal Carcinoma during Radiotherapy

BackgroundThe health-related physical fitness of patients with nasopharyngeal carcinoma can decrease significantly during radiotherapy, which can adversely affect their quality of life. AimThis study was designed to evaluate the potential influence of a multimodal exercise program on the health-related physical fitness and quality of life of patients with nasopharyngeal carcinoma during radiotherapy. MethodsForty patients with nasopharyngeal carcinoma undergoing radiotherapy in the First Affiliated Hospital of Fujian Medical University from May to November 2019 were included. The participants in the control group (N=20) received routine nursing, while those in the intervention group (N=20) were also subjected to the multimodal exercise program during radiotherapy. ResultsThe multimodal exercise program had a positive effect on participants. The step test index in the intervention group was significantly higher as compared to the control group (p < .05). The participants were subjected to 5 times slow speed (60°/s) and 10 times fast (180°/s) speed, and function of some extensor and flexor muscles of the elbow, shoulder, and knee joints in the intervention group was markedly improved (p < .05). In the intervention group, the grip strength of the right hand was observed to be significantly improved (p < .01). Furthermore, the upper limb scratch dorsal test of intervention group was significantly better than that of the control group (p < .05). The scores of physical, emotional, and social functions in the intervention group were found to be significantly higher as compared to the control group (p < .05). ConclusionsThe multimodal exercise program significantly improved the health-related physical fitness and life quality of the patients with nasopharyngeal carcinoma during radiotherapy, though its long-term effects remain to be further analyzed.

Diagnostic significance of myocardial and multimodal contrast exercise stress echocardiography in the detection of hemodynamically significant coronary artery stenosis in stable angina pectoris

Aim. To evaluate the diagnostic significance of myocardial contrast stress echocardiography (MCSE) and multimodal contrast stress echocardiography (MMSE) with dosed exercise in detecting hemo­dynamically significant coronary artery stenosis in patients with stable coronary heart disease (CAD) without impaired regional left ventricular contractility at rest.Material and methods. MCSE and MMSE were performed in 61 pa­­tients with suspected or stable CAD (mean age, 62,9±8,9 years). All patients underwent coronary angiography. During MCSE, perfusion and regional contractility were assessed. With MMSE, regional contractility was assessed. Sensitivity, specificity, and positive (LR+) and negative (LR-) likelihood ratios for MCSE and MMSE were assessed in com­parison with coronary angiography.Results. The sensitivity of MCSE with perfusion assessment was 82% (CI, 67-92%) with specificity of 70% (35-92%), LR+ — 2,74, LR- — 0,26. Sensitivity of MCSE with assessment of perfusion and regional contractility was 67% (50-81%) with specificity of 90% (65-99%), LR+ — 6,67, LR- — 0,37. The sensitivity of MCSE with an estimate of regional contractility of 74% (58-87%) with a specificity of 90% (56-98%), LR+ — 7,4, LR- — 0,28. The sensitivity of MMSE in the mode of cavitary and myocardial contrasting was 72% (55-85%) with a specificity of 90% (56-99%), LR+ — 7,18, LR- — 0,31.Conclusion. MCSE with an assessment of regional contractility and MMSE are of diagnostic importance in the detection of CAD, a positive result of which increases the post-test probability of hemodynamically significant coronary artery stenosis. A positive result of MCSE with dosed exercise with isolated perfusion assessment does not have a diagnostically significant effect on the post-test probability of CAD.

Effectiveness of Choreograph-exercise training versus Multi-modal exercise training on Cognitive function, Psycho-behavioral symptoms in Geriatrics Population: A Pilot Study

Background: Global population ageing is contributing to a growing public health crisis of cognitive impairment (CI), depression, anxiety, and stress. Cognitive dysfunction can affect a variety of cognitive processes, including attention, verbal and nonverbal learning, short-term and working memory, visual and auditory processing, problem-solving, processing speed, and motor functioning. The study aimed to compare the benefits of multi-modal exercise training to choreograph-based exercise training on psycho-behavioural symptoms and cognitive performance in the elderly population. Methods: The populations were distributed using a basic random sampling approach. Eight geriatric groups with cognitive impairment and psycho-behavioural alterations were the subjects of a comparative investigation. Training in choreographed exercises was given to Group A (n = 4), whereas training in multi-modal exercises was given to Group B (n = 4). The study's inclusion requirements required one to be 60 years of age or older. Both genders, MMSE scores 18–30, DASS scores 10–13 for depression, 8–9 for anxiety, and 15–18 for stress. Pre- and post-c Outcome indicators were assessed using MMSE and DASS. Results: A statistically significant (p&lt;0.05) effect was indicated by a within-group examination of all the outcome measures following the intervention. A statistically significant (p&lt;0.05) effect was indicated by a between-group examination of all the outcome measures following the intervention. Exercise training focused on choreography had a greater impact than the other group. Conclusion: The study found that in the senior population, choreograph-based exercise training was superior to multi-modal exercise training in terms of enhancing cognitive function and lowering psycho-behavioural symptoms.

The Exercise Intervention as Part of Rehabilitation in Intracranial Myxoid Chondrosarcoma: A Case Report

Malignant tumors after surgical trauma are frequently presented with unavoidable complications, such as physical dysfunction, decreased motor endurance, bowel disorders and cognitive impairment, and other symptoms. Due to the presence of malignant tumors, patients suffer from not only physical discomfort but also the presence of psychological and mental stress. Trauma often leads to poor emotional control and cannot cooperate with treatment. Exercise can not only change the function of the limbs but also have a positive effect on emotions. This case reports a 28-year-old male who experienced a decline in cognitive function and activities of daily living after undergoing tumor resection and radiotherapy. A year later, he was hospitalized and completed a four-week activity of daily living and exercise rehabilitation training. What’s more, his mood was managed along with the reintegration therapy. As the patient's mood improved, training coordination increased, quality of life and daily living ability gradually improved, and he recovered well during the follow-up period. Given this single case, multi-modal exercise rehabilitation can maintain or improve functional performance and QOL domains even during heavy treatments. When the patient is undergoing exercise rehabilitation, he also needs emotional management, and emotional intervention is required for the patient. Therefore, exercise and the emotional management of patients with malignancy are of great importance.

The therapeutic effects of multimodal exercise for people with Parkinson's: A longitudinal community-based study

IntroductionIndividuals with Parkinson’s Disease (PD) can develop a range of motor and non-motor symptoms due to its progressive nature and lack of effective treatments. Exercise interventions, such as multimodal (MM) programmes, may improve and sustain physical or cognitive function in PD. However, studies usually evaluate physical performance, cognition, and neuroprotective biomarkers separately and over short observation periods. MethodsPart one evaluates the effects of a weekly community-based MM exercise class (60 min) on physical function in people with PD (PwP). Exercise participants (MM-EX; age 65 ± 9 years; Hoehn and Yahr (H&Y) scale ≤ IV) completed a battery of functional assessments every 4 months for one (n = 27), two (n = 20) and three years (n = 15). In part two, cognition and brain-derived neurotrophic factor (BDNF) levels were assessed over 6-to-8 months and compared to aged-matched non-active PwP (na-PD, n = 16; age 68 ± 7 years; H&Y scale ≤ III) and healthy older adults (HOA, n = 18; age 61 ± 6 years). ResultsMM-EX significantly improved walking capacity (5% improvement after 8 months), functional mobility (11% after 4 months), lower extremity strength (15% after 4 months) and bilateral grip strength (9% after 28 months), overall, maintaining physical function across 3 years. Group comparisons showed that only MM-EX significantly improved their mobility, lower extremity strength, cognition and BDNF levels. ConclusionWeekly attendance to a community-based MM exercise group session can improve and maintain physical and cognitive function in PD, with the potential to promote neuroprotection.

Effects of Otago Exercise Program on postural control ability in elders living in the nursing home: A systematic review and meta-analysis.

Losing postural control ability and related injuries are of particular concern for elders living in the nursing home (NH). The Otago Exercise Program (OEP) is a multimodal exercise training program initially designed as an individually tailored home exercise for community-dwelling elders, but whether its movement characteristics and exercise intensity meet NH elders' needs still needs to be clarified. This study aimed to determine the effects of the OEP in enhancing postural control ability among elders in the NH. A systematic literature search of English language databases (Cochrane Library, PubMed, EMBASE, CINAHL, and Web of Science) and Chinese language databases (China National Knowledge Infrastructure, Wanfang, and Chongqing VIP) until 15 April 2022 were performed by 2 reviewers on searching randomized controlled trial (RCT) and non-RCT. A meta-analysis was performed using Review Manager 5.3 software. Continuous data were expressed as mean difference (MD) with 95% confidence intervals (95% CI). Dichotomous data were presented as risk ratios (RRs) with 95% CI. Study methodological quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions for RCTs and Risk Of Bias In Non-randomized Studies-of Interventions for non-RCTs by 3 reviewers. Nine studies with 546 participants were included in this review. Two hundred and sixty-nine participants received OEP, and 277 only had conventional exercise training. Compared to the conventional exercise training group, the NH elders in the OEP group have considerably decreased in fall risk (MD = -0.84; 95% CI = -1.17, -0.51; P < .00001) and positively increased in postural balance (MD = 5.55; 95% CI = 3.60, 7.50; P < .00001), functional mobility in short-distance (MD = -6.39; 95% CI = -8.07, -4.70; P < .00001), lower-limb muscle strength (MD = 4.32; 95% CI = 3.71, 4.93; P < .00001), and health status (risk ratio = 0.35; 95% CI = 0.18, 0.66; P = .001). Current evidence suggests that OEP is practical and feasible in NH. The nursing personnel can receive sufficient support for maintaining and enhancing these elders' postural control ability, especially during the COVID-19 pandemic.

Effects of an 8-week multimodal exercise program on ground reaction forces and plantar pressure during walking in boys with autism spectrum disorder

BackgroundAutism spectrum disorder is a developmental disability with first signs appearing in children aged 3 years and younger. Given that autism spectrum disorder is accompanied by a broad range of symptoms such as impaired sensory, neurological, and neuromotor functions, it appears plausible to argue that an intervention program focusing on multimodal exercise rather than single-mode exercise might be more effective in treating this wide variety of symptoms.ObjectiveThe aim of this study was to evaluate the effects of a multimodal exercise program entitled Sports, Play, and Active Recreation for Kids on variables of ground reaction forces and plantar pressure during walking in boys with autism spectrum disorder.MethodsTwenty-four autism spectrum disorder boys aged 7–11 years were recruited and randomly allocated into an intervention or a waiting control group. Sports, Play, and Active Recreation for Kids was conducted over a period of 8 weeks with three weekly sessions. This training protocol includes aerobic dance and jump rope exercises as well as running games. Pre- and post-training, ground reaction forces and plantar pressure variables were recorded while walking at a constant walking speed of 0.9 m/s using a foot scan embedded in a 15-m walkway.ResultsSignificant group-by-time interactions were found for the first peak of vertical ground reaction force, loading rate, and peak pressure at the medial heel region (all p = 0.001–0.49, d = 0.89–1.40). Post-hoc analyses showed significant pre-post decreases for the first peak of vertical ground reaction force (p = 0.001, d = 1.27), loading rate (p = 0.009, d = 1.11), and peak pressure at the medial heel region (p = 0.021, d = 1.01).ConclusionsOur results suggest that a joyful and multimodal exercise program has positive effects on kinetic walking characteristics of autism spectrum disorder boys. Accordingly, we recommend to implement this type of exercise in prepubertal autism spectrum disorder boys to improve gait kinetics.Trial registrationIranian Registry of Clinical Trials IRCT20170806035517N4. Registered on November 8, 2021. This study was approved by the Ethical Committee of the University of Mohaghegh Ardabili, Ardabil, Iran (IR.UMA.REC.1400.019). The study was conducted in accordance with the latest version of the Declaration of Helsinki.

Fostering physical activity-related health competence after bariatric surgery with a multimodal exercise programme: A randomised controlled trial

Regular physical activity (PA) supports the long-term success of bariatric surgery. However, integrating health-enhancing physical activity in daily life requires specific competences. In this study, we evaluated a multimodal exercise programme to build these competences.Forty adults who underwent bariatric surgery were randomised to a multimodal exercise programme or control group. Primary outcomes were the facets of PA-related health competences, namely the control competence for physical training, PA-specific affect regulation, motivational competence and PA-specific self-control. Secondary outcomes were PA behaviour and subjective vitality. Outcomes were assessed before, directly after the intervention and at 3 months follow-up.Significant treatment effects were found for control competence for physical training and PA-specific self-control but not for PA-specific affect regulation and motivational competence. Significant treatment effects were further observed for self-reported exercise and subjective vitality, all in favour of the intervention group. In contrast, no treatment effect was found for device-based PA. Overall, this study provides a foundation for future research to optimise long-term post bariatric surgery outcomes.