Physical Activity In Patients Research Articles

Accelerometer-measured physical activity in patients with heart failure and reduced ejection fraction: determinants and relationship with patient-reported health status

Abstract Background Accelerometer-measured physical activity is an increasingly used endpoint in heart failure (HF) trials. Purpose We aimed to investigate the determinants of accelerometer-measured physical activity and to establish the minimal clinically important difference (MCID). Methods Post-hoc analysis of the Empire HF trial, including stable outpatients with HF with reduced ejection fraction (HFrEF). Physical activity was quantified as average accelerometer counts per minute (CPM) with higher values representing higher activity. Associations between activity level and important clinical variables [age, sex, body mass index, N-terminal pro-brain natriuretic peptide, left ventricular ejection fraction (LVEF), atrial fibrillation, and anemia], as well as patient-reported health status (Kansas City Cardiomyopathy Questionnaire, KCCQ) were assessed. Results Complete data were available in 180 (95%) patients (86% male, mean age 65 years, mean LVEF 30%). Baseline median physical activity level was 1318 CPM (Q1-Q3 1111–1585). At baseline, age and anemia were independently associated with activity level (β-coefficients: -10 CPM per year age increase [95% CI -16 to -5.1], p = 0.00015, and -126 CPM for presence of anemia [95% CI -9.1 to -244], p = 0.035). Moreover, a significant independent association was observed between activity level and all KCCQ summary scores (β-coefficient point estimates of 3.7, 4.6, and 4.9 CPM, all p<0.02). For 12-week changes, only the KCCQ-clinical summary score (CSS) was associated with activity level, with a mean increase of 17.5 CPM [95% CI 1.5 to 34.0], p = 0.032, for every clinically relevant 5-point increase in KCCQ-CSS, corresponding to the MCID. Conclusion In patients with HFrEF, high age and anemia were independently associated with lower accelerometer-measured physical activity. Moreover, clinically relevant 5-point increases in Kansas City Cardiomyopathy Questionnaire clinical summary scores at 12 weeks were associated with an increase of 17.5 activity counts per minute, thus representing the minimal clinically important difference.Table 1.Baseline characteristicsFigure 1

Are digital health interventions valuable to support patients with cancer and caregivers? An umbrella review of web-based and app-based supportive care interventions.

Digital health technologies have expanded tremendously in the last two decades, creating an emerging research and clinical field. They are regarded as cost-effective, and their use in healthcare is prioritized by many countries. However, the constant evolution of these technologies has led to an abundance of related literature. Thus, we conducted an umbrella review to identify and characterize digital supportive care interventions for patients with cancer and their relatives. A preregistered umbrella review was conducted (PROSPERO registration number CRD42022333110). Five databases were searched (Embase, PsycINFO, PubMed, CINAHL, and the Cochrane Library). To be considered, studies had to be systematic reviews or meta-analyses, be performed on pediatric or adult patients with cancer or survivors or their relatives, report results on web-based or app-based supportive care interventions, and measure psychological, functional, or behavioral variables or quality of life related to cancer. The methodological quality of the studies was assessed using the AMSTAR-2 tool. Twenty eligible studies were identified. Most of the included studies reported results from adult patients with cancer. Globally, digital interventions were shown to be effective for physical activity in patients with cancer but had mixed results regarding emotional outcomes and quality of life. Additionally, a lack of methodological quality was noted for most of the included reviews. Digital supportive care interventions could be an effective tool in cancer care for some outcomes. Recommendations have been formulated for further research in this field using adapted methodologies for the development of digital health interventions.

Abstract 19041: The Role of Social Support in Functional Status and Physical Activity in Patients With Coronary Heart Disease: A 20-Year Analysis From the Heart and Soul Study

Introduction: Living with coronary heart disease (CHD) significantly impacts patients’ daily activities and physical exercise. Social support influences functional status and physical activity in patients with CHD. Multiple dimensions of social support may be associated with activities of daily living (ADL) and physical activity (PA) outcomes in patients with CHD. Hypothesis: Is higher perceived social support positively associated with ADLs and PA in patients who have lived with CHD for over 20 years? Methods: We analyzed data from the Heart and Soul prospective cohort study from 3-time points: 2000-2002, 2005-2007, and new data that were collected in 2022 among survivors of the original cohort. We measured social support using the Interpersonal Support Evaluation List (ISEL) with appraisal, belonging, and tangibility dimensions. Functional status was assessed using the Lawton (instrumental ADLs [IADLs]) and Katz scales (ADLs) and self-reported PA. Logistic mixed-effects models were employed, adjusting for ISEL dimensions, age, gender, socioeconomic status, ethnicity, marital status, and time. Results: Among 680 patients [(mean age at baseline 65.9 (SD10.2); 121 females (17.8%)], higher levels of appraisal (OR: 1.08; CI: 1.01-1.16) and belonging support (OR: 1.12; CI: 1.05-1.20) were significantly associated with higher IADL scores in the Lawton scale. Only belonging was significant in the Katz ADL scale (OR: 1.11; CI: 1.00-1.29). The tangible dimension was not significant in both scales. All dimensions exhibited significant positive associations with PA, with belonging support showing the strongest association (OR: 1.11; CI: 1.05-1.18) (P <.05 & 95% CI). A positive trend was observed between ADL and PA with ISEL dimensions, warranting further investigation of potential time-dependent effects. Conclusions: In this study examining 3-time points over 20 years, social support dimensions emerged as predictors of improved ADL and increased PA in patients with CHD. Results emphasize the need to foster social support as part of long-term care strategies.

Changes in physical function and physical activity in patients up to 5years after bariatric surgery.

Bariatric surgery is effective for patients with severe obesity, but relatively little is known about long-term functional outcomes. To describe physical fitness and activity changes among bariatric surgery patients in a clinical trial of physical activity interventions through 5 years postoperatively. Large bariatric center in the midwestern United States. Preoperatively, 6 months, and 5 years after surgery, 42 bariatric surgery patients wore an accelerometer to track activity and completed strength and cardiovascular endurance testing via treadmill, where estimated metabolic equivalents (METs) and ratings of perceived exertion (RPEs) were obtained. Preoperatively, 25% of patients reported exertion of <3 METs (equivalent to walking 2.5 mi/hr) as an RPE of 16 ("hard to very hard"). This decreased significantly to approximately 5% of patients 6 months and 5 years after surgery. Before surgery, 7.5% achieved ≥6 METs (vigorous activity) at an RPE of 16. This increased significantly to 36.6% at 6 months and 42.1% at 5 years after surgery. Body mass index and age, but no physical activity measure, predicted functional ability over time. The steps/d and exercise bout min/wk increased significantly from before surgery to 6 months postoperatively (4886.5 to 5948.5 steps and 23.8 to 66.6 bout min), but increases were not maintained at 5 years (5677.7 steps and 41.4 bout min). Conversely, moderate to vigorous min/ d increased progressively from before surgery (17.4) to 6 months (32.3) and 5 years (48.1) postoperatively. Functional abilities of bariatric surgery patients increased postoperatively and were maintained over 5 years. However, treadmill testing suggests that most patients are still unable to perform sustained activities of 6 METs (vigorous) or greater. Research is needed on bariatric patients' long-term function- and intervention- optimizing outcomes.

Critical review of evidence for the role of physical activity in the management of type 2 diabetes and physical activity in patients with diabetes in the state of Qatar

Globally prevalence of diabetes is increasing. Sedentary lifestyle and lack of physical activity is strongly associated with its prevalence and complications from the disease. This is also reflected in the people living in Qatar. Attempt to critically review the evidence on the effect of physical activity on diabetes and also review on the evidence available about the perception of people about physical activity in the state of Qatar. Critical appraisal of PubMed and google scholar using PICO model to gather the evidence available, including search of worldwide web for the terms ‘physical activity’, ‘diabetes mellitus type 2’. The results were critically appraised and presented in this review. Qatar has strong infrastructure of healthcare to support the people suffering from diabetes with its stable primary care, advanced secondary care and facilities. The municipalities have provided good green zones for the people to carry on the physical activity. The weather is not favorable throughout the year due to extremely hot summers but there are facilities which continue to function providing opportunities for physical activity. With the continued efforts of the governmental bodies increasing awareness, the perception of people is positive towards physical activity.

Level of physical activity in patients with type 2 diabetes

Level of physical activity in patients with type 2 diabetes

Minimal clinically important differences in walking capacity and physical activity after nonsurgical treatment in patients with lumbar spinal stenosis: a secondary analysis of a randomized controlled trial

BACKGROUND CONTEXTLittle information is available about the minimal clinically important differences (MCIDs) for objective physical measurements in people with lumbar spinal stenosis (LSS). PURPOSETo use disorder-specific anchor and, multiple anchor-, and distribution-based approaches to determine the MCIDs for walking capacity and physical activity in patients with LSS receiving nonsurgical treatment. STUDY DESIGN/SETTINGSecondary analysis of a randomized controlled trial. PATIENT SAMPLESixty-nine patients with neurogenic claudication caused by LSS receiving outpatient physical therapy. OUTCOME MEASURESZurich claudication questionnaire (ZCQ), self-paced walking test (SPWT), and number of daily steps measured by pedometry. METHODSAll patients completed the ZCQ, SPWT, and pedometry at the baseline and after 6 weeks. For the anchor-based approach, ZCQ symptom severity, physical function, and satisfaction subscales were used as the external anchors. Using the receiver-operating characteristic (ROC) curve, the MCIDs were determined based on the optimal cutoff points for changes in the SPWT or daily steps. For the distribution-based approach, the MCIDs were estimated from the standard deviations (SDs) of the baseline scores of the SPWT and daily steps. RESULTSIn the anchor-based approach, only the ZCQ satisfaction subscale for the SPWT (0.73), and ZCQ symptom severity subscale for daily steps (0.71) exceeded the area under the ROC curve value of 0.7, which is considered acceptable. When using these subscales as anchors, the ROC curves and optimal cutoff points indicated MCIDs of 151 m for the SPWT and 1,149 steps for daily steps. The distribution-based approach estimated the MCIDs as 280 m for the SPWT and 1,274 steps for daily steps, and had a moderate effect size (0.5 SD). CONCLUSIONSThe anchor-based approach had limited external responsiveness when the ZCQ was used as the anchor. However, this information may be helpful for interpreting walking capacity and physical activity in patients with LSS receiving nonsurgical treatment and for estimating power and sample size when planning new trials.

Factors associated to physical activity in patients with COPD: An ecological approach

BackgroundPhysical activity (PA) is low in patients with Chronic Obstructive Pulmonary Disease (COPD). Identifying modifiable and non-modifiable correlates of PA give understanding of the individual behavior and provide future directions for PA enhancing interventions. As PA is complex and multidimensional, it should be embedded within a thorough framework. ObjectiveTo identify correlates of PA in a comprehensive COPD population based on a broad ecological model, including physiological, psychological, socio-demographic and environmental dimensions. MethodsPA was objectively measured using the Dynaport Movemonitor and a comprehensive data collection of physiological, psychological, socio-demographic and environmental factors were collected. Bivariable and multivariable regression analyses (including principle component analysis) were executed. ResultsFor this cross-sectional analysis, we included 148 patients with COPD and valid PA data (mean (SD) age 68 (7) years, FEV1 57 (17) % predicted, 5613 (3596) steps per day). Significant bivariable associations were found for physiological (exercise capacity, muscle force, lung function, symptoms, comorbidities), psychological (e.g. fatigue, motivation, perceived difficulty with PA), socio-demographic (dog owning, use of activity tracker) and environmental (season, daylight, temperature) factors. Based on the multivariable regression model, exercise capacity, beliefs on motivation, importance and self-confidence regarding PA and weather conditions were independent correlates of mean steps per day (R2 = 0.35). Movement intensity during walking was only independently associated with exercise capacity and age (R2 = 0.41). ConclusionAlthough a wide range of potential influence factors were evaluated, variance in PA was only partly explained, supporting that PA is a complex behavior which is difficult to predict.

Physical activity of patients with chronic kidney disease

Introduction: The main causes of chronic kidney disease (CKD) are diabetic and hypertensive nephropathy. The incidence of civilization diseases is increasing, which also indirectly affects the increase in the incidence of CKD. The patient's therapy after the diagnosis should include the care of a multi-specialist therapeutic team that will remove as many restrictions as possible in everyday functioning and ensure a high quality of life. In addition to the selection of individual renal replacement therapy, i.a. physical rehabilitation. Despite the fact that in the course of chronic kidney disease physical activity is impaired by numerous pathophysiological processes, the patient should be encouraged to undertake physical activity in order to reduce the risk of death due to cardiovascular diseases, as well as to eliminate many other adverse health effects of the disease. The following paper aims to analyze the impact of physical activity on CKD patients and the pathophysiological causes of low physical activity in this group of patients and the possibility of implementing rehabilitation as an element of comprehensive therapy.&#x0D; Aim of the study: To review the current literature on the physical activity of patients with chronic kidney disease&#x0D; Materials and Methods: A review of the publications available in PubMed, using the key words „chronic kidney disease”, „psychical activity in chronic kidney disease”, physical activity”, „kidney failure”, „dialysis”, „renal rehabilitation”, „quality of life”

Integrating the wrist-worn tracker in cardiac rehabilitation programmes: a scoping review

Background/Aims Physical activity has been recommended as a secondary prevention strategy to reduce the risk of recurrent adverse events and improve health. While it can be challenging for health practitioners to motivate patients to remain physically active, wrist-worn activity trackers can assist in monitoring adherence. The aim of this study was to identify and summarise the existing scientific literature on wrist-worn activity trackers monitoring physical activity among patients undergoing cardiac rehabilitation. The authors also aimed to identify evidence gaps that require further investigation. Methods A systematic search was conducted in the electronic databases in PubMed, Web of Science, Scopus, SPORTDiscus and the Cumulative Index to Nursing and Allied Health Literature. Method quality was appraised using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews instrument. The study focused on any physical activity data collected by wrist-worn activity trackers in cardiac rehabilitation. Results A total of 19 relevant records were identified. Wrist-worn activity trackers generally improved the patient's physical activity and the validity of heart rate and step count measurements was acceptable. Conclusions Wrist-worn activity trackers can help to monitor patients' physical activity when undergoing cardiac rehabilitation. Further research is necessary to strengthen the evidence that wrist-worn activity trackers may be beneficial to evaluate clinical outcomes, determine the intervention cost, acceptability of patients and allied health professionals, as well as explore feedback, including technical issues.

Correlation of fatigue with disability and accelerometer-measured daily physical activity in patients with relapsing-remitting MS.

Fatigue is one of the most common symptoms in patients with multiple sclerosis (MS). Furthermore, measuring its effects on patients in daily life is challenging. This study aimed to discover the association between relapsing-remitting MS (RRMS) patients' disability, fatigue, and accelerometer-measured physical activity. A total of 41 patients with RRMS with an Expanded Disability Status Scale (EDSS) level of 0-5.5 and 20 healthy controls completed the Modified Fatigue Impact Scale (MFIS) and the Fatigue Severity Scale (FSS) questionnaires. The EDSS was evaluated for all patients with RRMS, and all participants performed the MS Functional Composite (MSFC) test and six-min walk test and wore an accelerometer for seven days. Patients with an EDSS level of 0-2.5 were found to have higher fatigue levels (p < 0.001) than healthy controls but lower levels than patients with an EDSS level of 3-5.5 (p < 0.001). A significant correlation was found to exist between fatigue and disability level measured by the EDSS (EDSS/FSS, r=0.750/p=0.001; EDSS/MFIS, r=0.661/p=0.001) and with the MSFC test in the patient group (MSFC/FSS, r=-0.350 p=0.025; MSFC/MFIS, r=-0.423/p=0.007). Total daily activity correlated with fatigue as measured by the FSS (MVPS/FSS r=-0.357/p=0.028, step count/FSS r=-0.463/p=0.003), but no correlation was found between the EDSS or the MSFC. A lower disability rate, better physical condition, and higher daily-living activity were found to predict lower fatigue levels.

Translation and cross-cultural adaptation of the mSQUASH into Spanish

BackgroundThere is a lack of outcome measures for the assessment of physical activity in patients with axial spondyloarthritis (axSpA). For this matter, the modified Short QUestionnaire to Assess Health (mSQUASH) was developed and validated, originally in Dutch. ObjectiveTo translate and cross-culturally adapt the mSQUASH into Spanish and to evaluate the equivalence of the translated version in patients with axSpA. MethodsThe mSQUASH was translated following forward-backward procedure according to the protocol of Beaton. Two bi-lingual translators produced independent forward translations of the mSQUASH into Spanish, and the versions were harmonized in a consensual version. Another translator back translated the synthesized version into Dutch. A scientific committee reached consensus on discrepancies and developed a pre-final version of the questionnaire. The field test with cognitive debriefing involved 10 patients with axSpA with different gender, age, disease duration, educational level and working status. ResultsThe translation process of the mSQUASH was completed without major issues. The first translation needed several iterations due to small discrepancies in the wording. Back-translation was performed without difficulties, and the scientific committee agreed upon a final version of the questionnaire. Cognitive debriefing showed the Spanish questionnaire to be clear, relevant, understandable and comprehensive. The preliminary version was accepted with minor modifications. ConclusionsThe resulting Spanish version of the mSQUASH showed good linguistic and face validity according to the field test, revealing potential for use in clinical practice and research. In order to conclude the cross-cultural adaptation of the mSQUASH into Spanish, the next step is the assessment of psychometric properties of the Spanish version.

Effect of physical activity on left ventricular dimensions and function after myocardial infarction: a systematic review.

Coronary artery disease is the major pathophysiological driver of ventricular remodeling. A multimodal intervention is the key strategy to promote a positive left ventricular remodeling with improvement in volumes and ejection fraction, known as "reverse remodeling." The aim of this review was to highlight the effect of physical activity (PA) on echocardiographic and cardiac magnetic resonance parameters of left ventricle in patients with myocardial infarction. We performed a systematic review of the literature to summarize current evidence about the efficacy (in terms of improvement in chamber dimensions, ejection fraction, speckle tracking and diastolic function) of physical activity in patients with myocardial infarction, supported by echocardiographic or magnetic resonance data. Articles were searched in Pubmed, Cochrane Library and Biomed Central. Only papers published in English and in peer-reviewed journals up to November 2022 were selected. After an initial evaluation, 1029 records were screened; the literature search identified 20 relevant articles. From this data, some PA protocols appeared to favor left ventricular reverse remodeling. PA provides beneficial effects on left ventricular parameters analyzed by echocardiography and cardiac magnetic resonance.

Features of Application of the Optimized Physical Rehabilitation Program in Patients with Coronary Heart Disease

Multisymptomatic coronary heart disease (CHD) remains a leading problem in cardiology. A person’s ability to perform physical work determines their quality of life, especially in patients with existing symptoms of damage to the cardiovascular system. The most advanced approach in the physical rehabilitation of patients with CHD is the use of ergometric testing indicators.&#x0D; The aim. To study the influence of the developed method of cycling training on the indicators of cardiopulmonary exercise (CPX) in patients with CHD.&#x0D; Materials and methods. We examined 65 men with CHD, I-II functional class stable angina pectoris, mean age 44.6 ± 1.39 years (from 32 to 60 years). The diagnosis was made on the basis of clinical findings, electrocardiography and laboratory examination according to the generally accepted criteria of the European Society of Cardiology.&#x0D; Results. The treatment results were evaluated two weeks after the completion of the physical rehabilitation program. Qualitative assessment was performed by using the CPX test with the recording of cardiac bioelectric potentials from 12 leads. The criteria for discontinuation of the test were generally accepted provisions based on WHO recommendations.&#x0D; While developing a physical rehabilitation program and predicting the timing of a functional recovery, several factors have to be taken into account that significantly affect the patient’s motor activity and determine the pace and outcome of the rehabilitation process as a whole. Long-term, regular physical activity in patients with CHD with limited coronary reserve have an impact on the mechanisms of cardiac function regulation, synchronization and optimization of the activity of the muscular, cardiovascular and respiratory systems. Systematic training sessions reduce the volume of drug therapy and can improve the patients’ quality of life.&#x0D; Conclusions. The use of the proposed individualized uniform interval cycling training combined with the intake of citrulline malate leads to a significant improvement in the achieved load capacity, heart rate, duration of work, total volume of completed work, inotropic reserve index, optimization of coronary blood circulation and improvement of bioenergy metabolism in the myocardium.

The association of weather conditions with day-to-day variability in physical activity in patients with COPD.

While patients with COPD often cite weather conditions as a reason for inactivity, little is known about the relationship between physical activity (PA) and weather conditions. The present study investigated the association of day-to-day weather changes on PA in patients with COPD and investigated patient characteristics related to being more or less influenced by weather conditions. In this longitudinal analysis, device-based day-by-day step counts were objectively measured in COPD patients for up to 12 months. Daily meteorological data (temperature, precipitation, wind speed, hours of sunlight and daylight) were linked to the daily step count and individual and multivariable relationships were investigated using mixed-model effects. Individual R2 was calculated for every subject to investigate the estimated influence of weather conditions on a patient level and its relationship with patient characteristics. We included 50 patients with a mean±sd follow-up time of 282±93 days, totalling 14 117 patient-days. Daily temperature showed a positive linear pattern up until an inflexion point, after which a negative association with increasing temperature was observed (p<0.0001). Sunshine and daylight time had a positive association with PA (p<0.0001). Precipitation and wind speed were negatively associated with PA (p<0.0001). The median per-patient R2 for overall weather conditions was 0.08, ranging from 0.00 to 0.42. No strong associations between patient characteristics and per-patient R2 were observed. Weather conditions are partly associated with PA in patients with COPD, yet the overall explained variance of PA due to weather conditions is rather low and varied strongly between individuals.

Comparison of the efficiency of the remote approaches for analgesia after total hip arthroplasty

Background. Recently, two blocks have been proposed: one of which is the most proximal and is called the erector spinae plane (ESP) block, the other is the most distal and is called pericapsular nerve group (PENG) block. Both techniques are performed under ultrasound control, are positioned as effective and safe, without muscle weakness. The purpose of the work: to evaluate the clinical effectiveness of the most remote approaches (ESP and PENG) for anesthesia in terms of the adequacy of analgesia and physical activity of patients after hip arthroplasty. Materials and methods. The study included 70 ASA II–III patients: 40 women and 30 men with an average age of 64.6 ± 10.7 years who underwent planned primary total hip arthroplasty for disease or fracture under spinal anesthesia. After the surgery, ESP block was performed in group I (n = 35), PENG block in group II (n = 35), 30 ml of 0.25% bupivacaine solution was injected. The ability to cover a distance of 30 meters without time limits, the maximum severity of the pain syndrome, the need for opioids (nalbuphine), the duration of the block and the number of patients with postoperative complications were evaluated. Results. The duration of PENG block was on average 8.6 (5.6–9.8) hours, which statistically significantly exceeded this indicator in patients who received ESP block with an average duration of 5 (3.8–6.0) hours (p &lt; 0.001). With comparable analgesia in both groups, patients who received PENG block required less time to walk the 30-meter distance — 31.0 (27.0–47.0) hours compared to those who received ESP block — 45.0 (32.0–54.0) hours (p = 0.006). In group II, 28.6 % of patients did not need opioids in the postoperative period, and this indicator in group I was only 8.5 % (p = 0.036), demonstrating the better analgesic potential of PENG block. Conclusions. Given the ease of implementation and safety of both regional methods, as well as the effectiveness of PENG block, it appears to be a real alternative to other regional methods in this category of patients.

Physical Activity and Blood Glucose Levels in Diabetes Mellitus Patients

Diabetes mellitus is a metabolic disease characterized by hyperglycemia. One of the risk factors and management of patients with diabetes mellitus is physical activity which can control blood glucose levels. This study aimed to determine the relationship between physical activity and blood glucose levels. The study design used correlation analysis with a cross-sectional approach. The population in this study was all type 2 diabetes mellitus patients at Abdoel Moeloek General Hospital Lampung. The sample used in this study was 52 respondents with consecutive sampling techniques. The research instrument for measuring physical activity was the physical activity level (PAL), and blood glucose level was measured using a glucometer, and data was analyzed using the Spearman Rho Test. The results showed that 32 respondents (61.5%) had mild physical activity, and 41 respondents (78.8%) had high blood glucose levels. The results showed a significant relationship between physical activity with blood glucose levels (p value=0,000; α&lt;0,05) in patients with diabetes mellitus at the Abdoel Moeloek General Hospital, Lampung. Physical activity can help the body to lower blood glucose by way of metabolism involving glucose stored in the muscles so that glucose in the blood will fill the glucose vacancies in the muscles. Higher the physical activity in patients with diabetes mellitus, the lower the glucose level.

Association of Possible Sarcopenia or Sarcopenia with Body Composition, Nutritional Intakes, Serum Vitamin D Levels, and Physical Activity among Patients with Type 2 Diabetes Mellitus in Taiwan.

This study estimates the association between sarcopenia and blood biochemical parameters, nutritional intake, anthropometric measurements, physical performance, and physical activity in patients with type 2 diabetes mellitus (T2DM). Participants were recruited from a primary care clinic in Kaohsiung City. According to the diagnosis criteria of the Asian Working Group for Sarcopenia (AWGS) in 2019, 110 patients with T2DM (aged 50-80 years) were divided into three groups: non-sarcopenia (n = 38), possible sarcopenia (n = 31), and sarcopenia (n = 41). Blood samples were collected, and nutritional intake was evaluated by a registered dietitian. A food frequency questionnaire and a Godin leisure-time exercise questionnaire were used to assess their daily vitamin D intake and physical activity. There were significant differences in age, serum vitamin D levels, nutritional intake, anthropometric measurements, and physical performance between the three groups. In elderly patients with T2DM, reduced serum 25-hydroxyvitamin D [25(OH)D] levels and daily energy intake were significantly associated with possible sarcopenia. Age, lower BMI, reduced serum 25(OH)D, and reduced dietary protein and vitamin D intake were significantly associated with sarcopenia. These findings may serve as the basis for intervention trials to reduce the prevalence of sarcopenia.

Prospective Real-World Analysis of Asthma Patients With Preserved and Reduced Physical Activity.

Asthma is a highly heterogeneous airway disease, and the clinical characteristics of patients with asthma with preserved and reduced physical activity are poorly understood. We aimed to investigate the risk factors and clinical phenotypes associated with reduced physical activity in a wide range of patients with asthma. We conducted a prospective observational study of 138 patients with asthma, including patients with asthma without chronic obstructive pulmonary disease (COPD) (n= 104) and asthma-COPD overlap (n= 34), and 42 healthy controls. Physical activity levels were measured for 2 weeks using a triaxial accelerometer at baseline and 1 year later. Higher eosinophils and body mass index (BMI) were associated with reduced physical activity in patients with asthma without COPD. Cluster analysis of asthma without COPD revealed 4 asthma phenotypes. We identified a cluster with preserved physical activity (n= 43) that was characterized by good symptom control and lung function and included a high proportion of biologics users (34.9%). Multivariate regression analysis revealed that patients with late-onset eosinophilic (n= 21), high-BMI noneosinophilic (n= 14), and symptom-predominant asthma phenotypes (n= 26) had lower levels of physical activity than controls. Patients with asthma-COPD overlap also had significantly lower physical activity levels than controls. Similar trends in physical activity levels were observed in each asthma group at 1-year follow-up. This study showed the clinical features of patients with asthma with preserved and reduced physical activity. Reduced physical activity was observed in various asthma phenotypes and in asthma-COPD overlap.

Interrelationship between arterial hypertension, health service costs, therapeutic treatment and physical activity

BackgroundArterial hypertension is a high prevalence disease that increase healthcare costs and affects physical activity level. This study aimed to analyse the interrelationship between arterial hypertension, health service costs, therapeutic treatment, and physical activity in patients with cardiovascular diseases.MethodCross-sectional study that evaluated 306 patients from a hospital in Presidente Prudente-Brazil. Based on their medical diagnosis, they were classified into multiple groups to access primary care and hospital-related costs variations. Then, using data from medical records and face to face interviews, they were examined on their treatment adherence and physical activity practice. Healthcare costs were accessed using medical records. Finally, the generalised linear model was used to analyse the interrelationship between treatment adherence, physical activity, health care costs and arterial hypertension. The data were analysed with Stata/MP4 16, and a p-value of less than 5% was used to determine statistical significance.ResultsThe group that adhered to the arterial hypertension treatments but were physically inactive presented higher costs with consultation (US$=24.1, 95%CI = 1.90;46,3)​​ medication (US$=56.60, 95%CI = 1.65; 111.5) and total primary health care costs (US$=71.60, 95%CI = 19.2; 123.9) even after adjusting for confounding variables, meanwhile those participants that adhered to the treatments and were physical active did not present difference in healthcare cost when compared to normotensive and physical active participants.ConclusionTo be adherent to hypertension treatment were related to higher health care costs meanwhile been physical activity were related to lower health care costs and the combination of both showed that be adherent and physical activity represent the same cost with health than those normotensive and active emphasizing the importance of adherence and physical activity in the hypertensive treatment.