Non-pharmacological Aids Research Articles

Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates

Primary dysmenorrhea (PD) is a common, disregarded, underdiagnosed, and inadequately treated complaint of both young and adult females. It is characterized by painful cramps in the lower abdomen, which start shortly before or at the onset of menses and which could last for 3 days. In particular, PD negatively impacts the quality of life (QOL) of young females and is the main reason behind their absenteeism from school or work. It is suggested that increased intrauterine secretion of prostaglandins F2α and E2 are responsible for the pelvic pain associated with this disorder. Its associated symptoms are physical and/or psychological. Its physical symptoms include headache, lethargy, sleep disturbances, tender breasts, various body pains, disturbed appetite, nausea, vomiting, constipation or diarrhea, and increased urination, whereas its psychological symptoms include mood disturbances, such as anxiety, depression, and irritability. While its diagnosis is based on patients’ history, symptoms, and physical examination, its treatment aims to improve the QOL through the administration of nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and/or the use of non-pharmacological aids (e.g., topical heat application and exercise). Patients must be monitored to measure their response to treatment, assess their adherence, observe potential side effects, and perform further investigations, if needed.

Этапное лечение расстройств аутистического спектра, ассоциированных с генетическим дефицитом фолатного цикла

В статье рассмотрено этапное лечение детей с расстройствами аутистического спектра, ассоциированными с генетическим дефицитом фолатного цикла, в свете новых открытий в патогенезе заболевания. Предложено разделить рекомендуемые терапевтические вмешательства на 3 последовательных этапа: противомикробное/противовирусное лечение, иммунотерапия при помощи в/в иммуноглобулина, нейрореабилитация с использованием инновационных медикаментозных средств и междисциплинарной немедикаментозной помощи. Особая форма аутистических расстройств, связанных с генетическим дефицитом фолатного цикла, в отличие от других генетических форм аутизма, является потенциально курабельной болезнью, и этапная стратификация терапевтических подходов позволяет добиться больших успехов в преодолении инвалидизирующих психических нарушений, которые ранее представлялись неизлечимыми.

Regular exercise counteracts circadian shifts in core body temperature during long-duration bed rest

With NASA’s plans for the human exploration of Mars, astronauts will be exposed to mission durations much longer than current spaceflight missions on the International Space Station. These mission durations will increase the risk for circadian misalignment. Exercise has gained increasing interest as a non-pharmacological aid to entrain the circadian system. To assess the potential of exercise as a countermeasure to mitigate the risk for circadian disorders during spaceflight, we investigated the effects of long-term head-down tilt bed rest (HDBR) with and without exercise on the circadian rhythm of core body temperature. Core body temperature was recorded for 24 h using a rectal probe in sixteen healthy men (age: 30.5 ± 7.5 years (mean ± SD)) after 7 days and 49 days of HDBR. Five participants underwent HDBR only (CTR), five participants underwent HDBR and performed resistive exercises (RE), and six participants underwent HDBR and performed resistive exercises superimposed with vibrations (RVE). The exercise was scheduled three times per week. CTR showed a phase delay of 0.69 h. In contrast, both exercise groups were characterized by a phase advance (0.45 h for RE and 0.45 h for RVE; p = 0.026 for interaction between time and group). These findings suggest that resistive exercise (with or without vibration) may also serve as a countermeasure during spaceflight to mitigate circadian misalignments. The results could also be important for increasing awareness about the role of circadian disorders in long-term bedridden patients.

Pain management for in-office hysteroscopy. A practical decalogue for the operator

Hysteroscopy is known to be the gold standard for evaluation of intrauterine pathologies, pre-menopausal and post-menopausal abnormal uterine bleeding and, in addition to this, it is a crucial examination in the infertility work-up. In-office operative hysteroscopy incorporates the outstanding possibility of seeing and treating an intracavitary pathology in the same examination, eliminating all the risk related to anesthesia and reducing procedure-related costs. By now, performing operative procedures in the office setting is recognized as feasible and safe. Over the last 20 years, many efforts have been made to implement the in-office operative approach worldwide. However, for some women, in-office hysteroscopy is still considered a painful experience, with reported discomfort at different steps of the hysteroscopic procedures. Moreover, uneventful and tedious sensations might be increased by a high level of anxiety for such examination. For this reason, despite the feasibility of the in-office approach, many clinicians are still afraid of provoking pain during the procedure and rather not to perform surgical procedures in the office, postponing the removal of the pathology in the operating room. To date, there is no consensus concerning pain management for in-office hysteroscopy and different approaches, pharmacological and non-pharmacological aids, as well as several procedural tips and tricks are utilized. Our purpose is to provide a feasible practical decalogue for the operator, to supply adequate management of pain during in-office hysteroscopic procedures, performing challenging operations, shrinking discomfort, aiming to upgrade both women’s and operator’s satisfaction.

Interventions to improve inpatients' sleep quality in intensive care units and acute wards: a literature review.

Sleep is essential for the physical and psychological restoration of inpatients, and lack of sleep results in sleep deprivation and poor sleep quality, with potentially harmful consequences. To summarise sleep-promoting interventions in the Intensive care unit (ICU) and acute ward setting. Six databases were searched to obtain studies for review and eight studies were selected, appraised, analysed and produced two themes: sleep-disturbing factors and sleep-promoting strategies. Sleep-disturbing factors included environmental factors (such as light and noise), illness-related factors (such as pain, anxiety and discomfort), clinical care and diagnostics. Sleep-promoting strategies included using pharmacological aids (medication) and non-pharmacological aids (reducing noise and disturbances, eye masks, earplugs and educational and behavioural changes). The literature review showed that both ICU and acute ward settings affect patients' sleep and both use similar strategies to improve this. Nevertheless, noise and sleep disturbances remain the most critical sleep-inhibiting factors in both settings. The review recommended future research should focus on behavioural changes among health professionals to reduce noise and improve patients' sleep.

Вплив нефармакологічних засобів на тренувальну діяльність студентів вищих навчальних закладів

Актуальність дослідження зумовлена впровадженням у навчально–тренувальний процес студентів, котрі займаються в групах підвищення спортивної майстерності, нефармакологічних засобів, до яких належать аромамасла та їх композиції, для підвищення функціональних резервів організму й ефективності тренувальної діяльності. Мета дослідження – виявлення ефектів спрямованого впливу аромакомпозицій (композицій рослинних ефірних масел) на функціональний, психоемоційний стан і фізичну працездатність студенток вищих навчальних закладів в умовах тренувальної діяльності. Результати дослідження. Результати дослідження свідчать, що в досліджуваній групі спостерігається тенденція до поліпшення психоемоційного стану, що видно з результатів тесту САН, який свідчить що активність підвищилась із 3,6±0,5 бала до 4,2±0,6 бала. На 14 % підвищився настрій, бажання працювати, порівняно з фоновими показниками, зросли з 3,6±0,5 до 4,2±0,6 бала. Самопочуття покращилося на 9 %. При накопиченні аромакомпозицій спостерігається зниження ЧСС у спокої 72,9±1,59 (75,9±1,56 на початку). Показник пульсового тиску на початку дослідження становив 45,6±0,87 од., після – 44,18±0,96 од. Індекс Робінсона після застосування аромасеансів становив 84,7±2,06 од., Індекс Руф’є – 6,50±1,1 бала, ЕГК змінилась з 7,11±0,27 см до 8,35±0,23 см. Результати технічних дій зросли в середньому від 5 % до 44,1 %, показники ефективності ігрових дій при подачі підвищилися із 37,54 до 41,62 %; ігрових дій при захисті зросли з 43,16 до 46,20 %; ігрових дій у нападі з 46,13 % до 50,08 %; ігрових дій у прийомі зросли з 42,38 до 48,47 %. Тобто всі показники ігрових дій збільшились від 9 до 19 % після педагогічного експерименту.

Ambulatory blood pressure response to a bout of HIIT in metabolic syndrome patients.

The effectiveness of exercise to lower blood pressure may depend on the type and intensity of exercise. We study the short-term (i.e., 14-h) effects of a bout of high-intensity aerobic interval training (HIIT) on blood pressure in metabolic syndrome (MetS) patients. Nineteen MetS patients (55.2±7.3years, 6 women) entered the study. Eight of them were normotensive and eleven hypertensive according to MetS threshold (≥130mmHg for SBP and/or ≥85mmHg for DBP). In the morning of 3 separated days, they underwent a cycling exercise bout of HIIT (>90% of maximal heart rate, ~85% VO2max), or a bout of isocaloric moderate-intensity continuous training (MICT; ~70% of maximal heart rate, ~60% VO2max), or a control no-exercise trial (REST). After exercise, ambulatory blood pressure (ABP; 14h) was monitored, while subjects continued their habitual daily activities wearing a wrist-band activity monitor. No ABP differences were found for normotensive subjects. In hypertensive subjects, systolic ABP was reduced by 6.1±2.2mmHg after HIIT compared to MICT and REST (130.8±3.9 vs. 137.4±5.1 and 136.4±3.8mmHg, respectively; p<0.05). However, diastolic ABP was similar in all three trials (77.2±2.6 vs. 78.0±2.6 and 78.9±2.8mmHg, respectively). Motion analysis revealed no differences among trials during the 14-h. This study suggests that the blood pressure reducing effect of a bout of exercise is influence by the intensity of exercise. A HIIT exercise bout is superior to an equivalent bout of continuous exercise when used as a non-pharmacological aid in the treatment of hypertension in MetS.

Effects of physical activity in Parkinson's disease: A new tool for rehabilitation.

Parkinson's disease (PD) is a common neurodegenerative disease characterized by bradykinesia, tremor, rigidity, and postural instability. Motor disorders are composite and combined, adversely affecting the patient's health. Tremor and rigidity are correlated with worsening manual dexterity as well as postural changes such as akinesia and camptocormia. Moreover, gait alteration as well as postural instability, with consequent impairment in balance, increase the risk of falls. It is well known that these symptoms respond poorly to pharmacologic therapy in PD patients. Physical therapy is the most effective non-pharmacological aid to PD patients. Available data in the literature indicate that any rehabilitation protocol has to focus on: cognitive movement strategies, cueing strategies, and improved physical capacity and balance. Different training programs for PD patients have been designed and evaluated but only specific training strategies, tailored and individualized for each patient, may produce improvements in gait speed and stride length, decrease motor and balance symptoms and improve quality of life. Furthermore, aerobic training may improve muscle trophism, strength and mobility. It seems reasonable to state that tailored physical activity is a valid tool to be included in the therapeutic program of PD patients, considering that this approach may ameliorate the symptoms as well as the overall physical incapacity, reduce the risk of falls and injuries, and ultimately improve quality of life.

Isometric handgrip does not elicit cardiovascular overload or post-exercise hypotension in hypertensive older women

BackgroundArterial hypertension is a serious health problem affecting mainly the elderly population. Recent studies have considered both aerobic and resistance exercises as a non-pharmacological aid for arterial hypertension treatment. However, the cardiovascular responses of the elderly to isometric resistance exercise (eg, isometric handgrip [IHG]) have not yet been documented.ObjectiveThe purpose of this study was to investigate cardiovascular responses to different intensities of isometric exercise, as well as the occurrence of post-isometric exercise hypotension in hypertensive elderly people under antihypertensive medication treatment.Patients and methodsTwelve women volunteered to participate in the study after a maximal voluntary contraction test (MVC) and standardization of the intervention workload consisting of two sessions of IHG exercise performed in four sets of five contractions of a 10-second duration. Sessions were performed both at 30% of the MVC and 50% of the MVC, using a unilateral IHG protocol. Both intensities were compared with a control session without exercise. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) at rest (R), during peak exercise (PE), and after 5, 10, 15, 30, 45, and 60 minutes of post-exercise recovery were evaluated.ResultsNo significant changes were observed after isometric exercise corresponding to 30% MVC for either SBP (R: 121 ± 10; PE: 127 ± 14; 5 min: 125 ± 13; 10 min: 123 ± 12; 15 min: 122 ± 11; 30 min: 124 ± 11; 45 min: 124 ± 10; 60 min: 121 ± 10 mmHg) or DBP (R: 74 ± 9; PE: 76 ± 6; 5 min: 74 ± 5; 10 min: 72 ± 8; 15 min: 72 ± 5; 30 min: 72 ± 8; 45 min: 73 ± 6; 60 min: 75 ± 7 mmHg). Similarly, the 50% MVC did not promote post-isometric exercise hypotension for either SBP (R: 120 ± 7; PE: 125 ± 11; 5 min: 120 ± 9; 10 min: 122 ± 9; 15 min: 121 ± 11; 30 min: 121 ± 9; 45 min: 121 ± 9; 60 min: 120 ± 7 mmHg) or DBP (R: 72 ± 8; PE: 78 ± 7; 5 min: 72 ± 7; 10 min: 72 ± 8; 15 min: 71 ± 7; 30 min: 72 ± 8; 45 min: 75 ± 10; 60 min: 75 ± 7 mmHg).ConclusionOur data reveal that cardiovascular overload or post-exercise hypotension did not occur in elderly women with controlled hypertension when they undertook an IHG session. Thus this type of resistance exercise, with mild to moderate intensity, with short time of contraction appears to be safe for this population.

Enhancing Athletic Performance through the Administration of Peppermint Odor

Previous research has indicated that odorant presentations can have both positive and negative effects on psychological perceptions of athletic task performance. The present study extends past research by assessing how the administration of peppermint odor affects actual athletic task performance. Forty athletes undertook a series of physical tasks under conditions of no-odor or peppermint odor. The peppermint odor condition resulted in increases in running speed, hand grip strength, and number of push-ups, but had no effect on skill related tasks such as basketball free-throw shots. The implications are particularly salient in regard to enhancing athletic performance using a nonpharmacological aid and as an adjunct to athletic training and physical therapy.

THE ANTI-HYPERTENSIVE EFFECT OF ACUTE EXERCISE IS SUSTAINED DURING SUBSEQUENT BOUTS OF MILD EXERCISE AND SIMULATED ACTIVITIES OF DAILYLIVING

2019 It is known that an acute bout of exercise may result in a transient decrease in post exercise blood pressure. However, it is not known whether this decrement only occurs at rest in a controlled environment or whether it persists during activities of daily living. The latter phenomenon would be of clinical significance. Eight recreationally active participants, with low borderline hypertension performed 30 min of cycle ergometry at 70% V̇O2Peak or 30 min of quiet seated rest on separate days (randomized order). Following exercise and rest, they completed a 70 min protocol of mild exercise and simulated activities of daily living (ADL). Radial arterial pressure was monitored throughout by intra-arterial catheterization. Prior exercise resulted in lower systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP) throughout the post exercise ADL than the values observed without prior exercise. The maximal difference in SBP, DBP and MAP between trials was 26, 7 and 13 mmHg respectively. This relative hypotension occurred in spite of higher heart rates during the ADL measurement period following the prior exercise. Furthermore, many of the blood pressure measurements during the post exercise period were significantly lower than the pre exercise values during the same trial. We conclude that post exercise hypotension persists during mild exercise and simulated activities of daily living. Although the duration of this hypotension needs to be determined, acute exercise may serve as a non-pharmacological aid in the treatment of hypertension. Supported by the Natural Sciences and Engineering Research Council of CANADA.

THE EFFECTS OF EXERCISE DURATION ON POST EXERCISE HYPOTENSION

102 Study 1. Thirteen normotensive volunteers with average baseline blood pressure of 126 / 71 mmHg participated in the study. Participants performed bouts of cycle ergometry for 15, 30 and 45 min at 70% V̇O2 Peak. Blood pressure was monitored by the Finapres method with 2 min windows recorded at rest, 5, 10, 15, 30, 45 and 60 min post exercise. Following exercise, SBP was similar between the three trials and became hypotensive at 5 through 60 min of measurement. DBP was also unaffected by the duration of exercise and was lower than before exercise at 30 through 45 min post exercise. Study 2. Eight borderline hypertensive volunteers with average baseline blood pressure of 133 / 79 mmHg participated in the study. Subjects performed bouts of cycle ergometry for 10 and 30 min at 70% V̇O2 Peak. Following exercise, blood pressure was monitored as in study 1. SBP was similar between both trials and became hypotensive at 5 through 60 minutes post exercise. The largest decrement of SBP was 14 mmHg and occurred 15 min post exercise. DBP was also unaffected by the duration of exercise and was lower than pre-exercise levels at 5 min and again at 15 through 45 min post exercise. MAP also showed significant decrements throughout the entire 1 hr post exercise period by a maximum of 9 mmHg at 15 min post exercise, irrespective of exercise duration. We conclude that moderately intense exercise may be as brief as 10 min in duration in order to elicit a decrease in resting blood pressure and may have potential benefits as a non-pharmacological aid to hypertension. Supported by the Natural Sciences and Engineering Research Council of CANADA