Exercise In Patients Research Articles

Factors influencing adherence to Physical Exercise in patients with multiple sclerosis: a systematic review focusing on Exercise over General Physical Activity.

While the barriers and facilitators of physical activity adherence are well-defined, there is a limited number of studies focusing specifically on exercise adherence, which is crucial to identify in patients with multiple sclerosis (MS) due to its known disease-modifying effect. To investigate the factors affecting adherence to physical exercise in MS patients. Literature search was conducted in PubMed, Cochrane, Web of Science, and Scopus electronic databases up to the current date. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS) for quantitative studies and the McMaster Critical Appraisal Tool for qualitative studies, with evidence synthesis conducted using the Modified Bakker Scale. The systematic review incorporated thirteen studies, consisting of seven qualitative and six quantitative ones. These studies' methodological quality was high; 12 were high, and the other was medium (unclear). In all reviewed studies, the primary patient-related and environmental barriers with high levels of evidence regarding exercise adherence included fatigue (38%), false beliefs (18%), cost (18%), and lack of time (15%). Barriers identified in very few studies included cognitive problems (3%), bladder-bowel problems (3%), and family support and advice (3%), indicating a necessity for further research to reveal their impact on exercise adherence. The scarcity of studies on exercise barriers in MS is partly due to the absence of reliable assessment methods for evaluating exercise adherence, along with the prevalent emphasis on physical activity. Future research should prioritize the development of adherence scales tailored to physical exercise and shifting focus towards less explored barriers.

Impact of controlled physical training on clinicopathological and psychophysiological features of patients with chronic heart failure and type 2 diabetes

Aim. To evaluate the effectiveness of long-term (five-year) supervised physical exercise in patients with chronic heart failure (CHF) following myocardial infarction (MI) and type 2 diabetes mellitus (T2DM).Materials and Methods. The study included 88 patients with CHF of functional class II-III after MI and concomitant T2DM. In addition to standard medication therapy, patients in the main group (n = 42) performed regular moderate-intensity physical exercises for 30−60 minutes at least 5 days a week. The control group consisted of 46 patients who received standard medication therapy. Patients in both groups had similar clinical and demographic characteristics. After 5 years of follow-up, we assessed the incidence of a composite endpoint (death, MI, emergency myocardial revascularization, acute CHF decompensation), quality of life (measured by the SF36 questionnaire), levels of anxiety and depression (measured by the HADS questionnaire), and levels of fatigue (measured by the MFI-20 questionnaire). By the end of the five-year observation period, data were available for 40 patients in the main group (11 patients were excluded from the study due to discontinuation of regular physical exercise) and 42 patients in the control group.Results. The incidence of the composite endpoint was 55.2% and 80.9% in main and control group, respectively (p = 0.038). Regular physical exercise over the five-year period was associated with a higher quality of life according to the SF36 questionnaire (64.5 [63.1; 67.8] vs. 49.2 [48.4; 49.8], p = 0.001), lower levels of anxiety (5.8 [5.1; 7.7] vs. 8.0 [6.8; 9.2], p = 0.042) and depression (2.9 [2.2; 4.2] vs. 10.7 [10.5; 12.3], p = 0.001) according to the HADS questionnaire, and lower levels of general fatigue according to the MFI-20 questionnaire (9.1 [8.5; 11.2] vs. 15.1 [14.5; 15.4], p = 0.019).Conclusion. Long-term regular physical exercise in patients with CHF and T2DM improves cardiovascular outcomes and psychological status of patients.

Physical activity and exercise in chronic kidney disease: consensus statements from the Physical Exercise Working Group of the Italian Society of Nephrology

The Italian Society of Nephrology has tasked its Working Group on Physical Exercise with developing a consensus statement document on physical activity and exercise in patients with chronic kidney disease (CKD). This paper consists of 16 points that were discussed, and approved using the mini-Delphi method by 15 members of the working group. Each statement is based on a comprehensive review of the literature, clinical experience, and expert opinions. Overall, the statements affirm that regular physical activity and exercise training offer numerous benefits to CKD patients, including improved physical function, enhanced cardiometabolic and neuromuscular function, cognitive benefits, and an overall improvement in quality of life. Furthermore, exercise may provide nephroprotection and reduce mortality. These advantages are observed across all CKD stages, whether on conservative therapy or kidney replacement therapy (hemodialysis or peritoneal dialysis), and in kidney transplant recipients. Moreover, when physical activity and exercise training are implemented with appropriate precautions, they are safe in CKD patients. Gradual physical activity and customized exercise programs should be tailored to the patient's exercise tolerance, potentially enhancing compliance. Clinicians are encouraged to use a series of questionnaires and tests to assess the patient's level of physical activity and performance. However, exercise and physical activity are poorly implemented in clinical practice due to many barriers related to patients and healthcare staff. Overcoming these barriers requires the proactive role of the nephrologists, who should actively incorporate exercise training and promote physical activity within routine care plans. Adopting a multidisciplinary team approach, which includes nephrologists, nurses, exercise professionals, and dietitians, is crucial for providing comprehensive rehabilitation for CKD patients. Integrating new technologies and remote check ups could further enhance the effectiveness of these interventions.Graphical abstract

Prehabilitation Consultation on Self-Care and Physical Exercise in Patients Diagnosed with Abdominopelvic Cancer: Protocol of the Study.

Introduction: Prehabilitation in the field of oncology has been defined as "the process in the continuum of care that occurs between diagnosis and the start of treatment involving physical and psychological measures that determine the patient's baseline functional status." To determine the effectiveness of a Prehabilitation consultation on self-care and targeted physical exercise for patients diagnosed with abdominopelvic cancer. An observational study that will evaluate the pre-post efficacy of an ad-hoc designed Prehabilitation intervention. The study population consists of patients diagnosed with colon or gynecological cancer with a surgical indication as part of their therapeutic plan from the General Surgery Services. It is configured around four key interventions: (a) health education and self-care, (b) specific nutritional counseling, (c) initial psychological assessment, and (d) directed physical exercise intervention. Health education, self-care interventions, and physical exercise will be carried out weekly from diagnosis to the scheduled surgery day. Aspects such as self-care capacity or agency, perioperative anxiety, aerobic capacity, strength and flexibility, postoperative complications, and recovery time to adjuvant treatment will be measured using tools such as Appraisal of self-care agency scale (ASA), State Trait Anxiety Inventory (STAI), walking test, sit and Reach, Hand Grip or Squad Jump. Utilizing validated tools for analyzing selected variables will contribute to refining and expanding care guidelines, ultimately enhancing support for both patients and their caregivers.

Impact of Physical Exercise on Levodopa Therapy Across Parkinson's Disease Stages.

Levodopa is the gold standard of treatment in Parkinson's disease (PD). Its clinical effect changes as the disease progresses. Wearing off is a frequent first manifestation of motor fluctuations. Some patients with advanced PD report faster wearing off after physical exercise. The aim was to assess if pharmacokinetics of levodopa is influenced by physical exercise in patients with different disease advancement. 22 patients with PD (12 untreated with levodopa and 10 with motor fluctuations) and 7 healthy controls (HC) were included. Plasma samples were collected at 9 fixed timepoints following administration of levodopa/benserazide 200/50 mg for two days: rest day and standardized physical exercise day. Clinical assessment with Unified Parkinson Disease Rating Scale part III (UPDRS III) was performed in fixed timepoints. Liquid chromatography-tandem mass spectrometry was used to measure levodopa concentrations. No differences between the HC, levodopa naïve and advanced PD groups were observed regarding selected pharmacokinetic parameters. In advanced PD and HC no differences in pharmacokinetic parameters of levodopa with and without effort were observed. In levodopa naïve PD group higher mean residence time after rest than after exercise (168.9±48.3 min vs. 145.5±50.8 min; p = 0.026) was observed. In advanced PD group higher UPDRS III score (14.45±5.5 versus 20.9±6.1 points, p = 0.04) was observed after exercise. The deterioration of motor status of advanced PD patients after physical effort is not reflected by changes in pharmacokinetics but rather mediated by central mechanisms.

Effect of a multimodal intervention in breast Cancer patients undergoing neoadjuvant therapy: A study protocol of the multimodal project

Background and aimsTo determine the effect of a multimodal intervention (nutritional behavior change and physical exercise) on quality of life, chemotherapy response rate and tolerance, histopathological level of the tumor, body composition, and biochemical parameters, in patients diagnosed with breast cancer during neoadjuvant chemotherapy treatment, and to compare them with the control group. MethodsAnticipated 80 patients diagnosed with breast cancer aged 18–70 years will be recruited for this randomized, unblinded clinical trial based on a nutritional behavior change and physical exercise in patients during the approximately 6 months in which the patient receives neoadjuvant treatment. Participants will be randomly allocated (1:1) to one of two groups (intervention or control). Primary and secondary outcomes will be assessed before the beginning and after the neoadjuvant treatment (before surgery). The primary outcome is quality of life, whereas secondary outcomes include chemotherapy response rate and tolerance, histopathological level of the tumor and body composition (i.e., visceral adipose tissue activity, bone, lean and fat masses). We will analyze blood parameters (i.e., biochemical, inflammatory, and tumor markers) as exploratory outcomes. ConclusionThis study will address the influence of a practical and viable multimodal intervention (i.e., nutritional behavior change and physical exercise) on breast cancer patients undergoing neoadjuvant chemotherapy. Given the practical viability of the intervention in real-world settings, our study holds promise for significant scientific and clinical implications.

Design and development of a wrist rehabilitation device with an interactive game

In this paper, a wrist rehabilitation device integrated with an interactive game is developed. The device is designed for flexion/extension and ulnar/radial motions. The motion of the wrist joint is measured by an optical encoder. A hall sensor is also used to measure the force emitted from the DC motor. These data are fed back to the interactive gaming environment to create the movement of goals in the video game. There are two types of interactive games designed. The first requires the practitioner to move their wrist to achieve a specific goal. The second exercise requires the practitioner to move their wrist joint continuously to reach moving targets. In the game interface, therapists can easily adjust training intensity, training time, and change training limits depending on the recovery status of the patients. At the same time, it also records the patient's training efforts and monitors visual graphs of performance during exercise. The experiments were conducted to tune the games and to get a preliminary evaluation of the device. The feedback from the patients and therapists are recorded to improve the device and game interfaces. Game parameters are adjusted during the patient's exercise process under the supervision of a physiotherapist. The values of rotation angle and torque are collected and then presented in graphs so that physiotherapists can assess the patient's recovery status. The results show that the patients enjoy the games. The therapist is satisfied with the game interface and says that the games are intuitive and easy to play.

WCN24-1307 Perception of benefits and barriers to physical exercise in patients undergoing hemodialysis: a multicenter study with Brazilian patients

WCN24-1307 Perception of benefits and barriers to physical exercise in patients undergoing hemodialysis: a multicenter study with Brazilian patients

Endurance training and hydroxyurea have synergistic effects on muscle function and energetics in sickle cell disease mice

Sickle cell disease (SCD) is an hemoglobinopathy resulting in the production of an abnormal Hb (HbS) which can polymerize in deoxygenated conditions, leading to the sickling of red blood cells (RBC). These alterations can decrease the oxygen-carrying capacity leading to impaired function and energetics of skeletal muscle. Any strategy which could reverse the corresponding defects could be of interest. In SCD, endurance training is known to improve multiples muscle properties which restores patient's exercise capacity but present reduced effects in anemic patients. Hydroxyurea (HU) can increase fetal hemoglobin production which can reduce anemia in patients. The present study was conducted to determine whether HU can improve the effects of endurance training to improve muscle function and energetics. Twenty SCD Townes mice have been trained for 8 weeks with (n = 11) or without (n = 9) HU. SCD mice muscle function and energetics were analyzed during a standardized rest-exercise-recovery protocol, using Phosphorus-31 Magnetic resonance spectroscopy (31P-MRS) and transcutaneous stimulation. The combination of training and HU specifically decreased fatigue index and PCr consumption while muscle oxidative capacity was improved. These results illustrate the potential synergistic effects of endurance training and HU on muscle function and energetics in sickle cell disease.

Investigation of Medical Image Technology Based on Big Data Neuroscience in Exercise Rehabilitation.

The purpose of this article is to combine the functional information of CT images with the anatomical and soft tissue information of MRI through image fusion technology, providing more detailed information for rehabilitation treatment and thus providing a scientific basis for clinical applications and better training plans. In this paper, functional brain imaging technology combining CT (computed tomography) and MRI (magnetic resonance imaging) was used for image fusion, and SURF (accelerated robust feature) feature points of images were extracted. In this study, 40 patients with mild and moderate closed traumatic brain injury admitted to the rehabilitation department of a rehabilitation center from 2018 to 2022 were selected as the research objects. Compared with using only CT images and MRI images for brain injury diagnosis, the fusion image had a higher detection rate of abnormal brain injury diagnosis, with a detection rate of 97.5%. When using fused images for the diagnosis of abnormal brain injury, the patient's exercise rehabilitation effect was better. CT and MRI image fusion technology had a high diagnostic accuracy for brain injury, which could timely guide doctors in determining exercise rehabilitation plans and help improve the effectiveness of patient exercise rehabilitation.

Beneficial effects of physical exercise on the osteo-renal Klotho-FGF-23 axis in Chronic Kidney Disease: A systematic review with meta-analysis.

The aim of this study was to investigate the efficacy of physical exercise in chronic kidney disease, describing its impact on the Klotho-FGF23 axis. PubMed, Web of Science and Scopus databases, updated to January 2023, were searched. The present study employed mean difference and a 95% confidence interval (CI) to examine the efficacy of the intervention. Heterogeneity was assessed through inconsistency statistics (I2). Out of the 299 studies identified, a total of 4 randomized controlled trials (RCTs), comprising 272 participants, met the eligibility criteria. Compared with the control group, physical exercise significantly decreased the concentrations of FGF23 (MD: -102.07 Pg/mL, 95% CI: -176.23.47, -27.91 I2= 97%, p = 0.001), and a significantly increased the concentrations of Klotho protein: (MD: 158.82 Pg/mL, 95% CI: 123.33, -194.31, I2 = 0%, p = 0.001). The results of our study indicated that the exercise has a direct relationship with Klotho-FGF23 axis. We can conclude that physical exercise in patients with CKD produces beneficial effects on the pathophysiological components related to this disease, including cardiorespiratory fitness and vascular functions. As observed, both endurance and aerobic physical exercise increase Klotho production and decrease FGF23 levels. Evidence indicates that exercise attenuates the progression of CKD, improves uremic parameters and down-regulates inflammation-related markers.

Optimising Rehabilitation Strategies for Postpartum Elderly Gravida with In Vitro Fertilisation Conception

Optimising Rehabilitation Strategies for Postpartum Elderly Gravida with In Vitro Fertilisation Conception

Physical exercise in patients with testicular cancer treated with bleomycin, etoposide and cisplatin chemotherapy: pulmonary and vascular endothelial function—an exploratory analysis

PurposeBleomycin, etoposide, and cisplatin combination chemotherapy (BEP) improves the survival of patients with testicular cancer, but is associated with potentially life-threatening toxicities like pneumonitis and thromboembolic events. This study explored the effects of physical exercise in patients with testicular cancer during or after BEP-chemotherapy on pulmonary and vascular endothelial toxicity.MethodsIn this post hoc analysis of a multicenter randomized clinical trial (NCT01642680), patients with metastatic testicular cancer scheduled to receive BEP-chemotherapy were randomized to a 24-week exercise intervention, initiated during (group A) or after BEP-chemotherapy (group B). Endpoints were pulmonary function (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), lung transfer-coefficient and transfer factor for carbon monoxide (KCO, DLCO) and markers of vascular endothelial dysfunction (von Willebrand factor (vWF) and factor VIII).ResultsThirty patients were included. Post-chemotherapy, patients declined less in FVC, FEV1 and DLCO in group A compared to group B. Post-chemotherapy, vWF and factor VIII were significantly lower in group A compared to group B. After completion of exercise, started either during BEP-chemotherapy or thereafter, no between-group differences were found. At 1-year post-intervention, significant between-group differences were found in favour of group A in DLCO and KCO.ConclusionsPatients who exercised during BEP-chemotherapy better preserved FVC, FEV1 and DLCO, measured directly post-chemotherapy and 1-year post-intervention (DLCO, KCO). This coincided with less increase in vWF and factor VIII measured directly post-chemotherapy. These data support a beneficial role of a physical exercise intervention during BEP-chemotherapy on pulmonary and vascular damage in patients with testicular cancer.Trial registryOptimal Timing of Physical Activity in Cancer Treatment (ACT) Registry URL: https://clinicaltrials.gov/ct2/show/NCT01642680. Trial registration number: NCT01642680.

Physical exercise in kidney disease: A commonly undervalued treatment modality.

Physical inactivity has been identified as a risk factor for multiple disorders and a strong association exists between chronic kidney disease (CKD) and a sedentary lifestyle. Even though physical activity is crucial in the development and progression of disease, the general focus of the current medical practice is the pharmacological perspective of diseases with inadequate emphasis on lifestyle intervention. In this narrative review we explain the pathophysiological mechanisms underlying the beneficial effects of physical exercise on CKD in addition to discussing the clinical studies and trials centred on physical exercise in patients with CKD. Physical activity influences several pathophysiological mechanisms including inflammation, oxidative stress, vascular function, immune response and macromolecular metabolism. While exercise can initially induce stress responses like inflammation and oxidative stress, long-term physical activity leads to protective countermeasures and overall improved health. Trials in pre-dialysis CKD patients show that exercise can lead to reductions in body weight, inflammation markers and fasting plasma glucose. Furthermore, it improves patients' functional capacity, cardiorespiratory fitness and quality of life. The effects of exercise on kidney function have been inconsistent in these trials. In haemodialysis, peritoneal dialysis and kidney transplant patients exercise interventions improve cardiorespiratory fitness, walking capacity and quality of life. Combined training shows the best performance to increase peak oxygen uptake in haemodialysis patients. In kidney transplant recipients, exercise improves walking performance, quality of life and potentially arterial stiffness. However, exercise does not affect glucose metabolism, serum cholesterol and inflammation biomarkers. Long-term, adequately powered trials are needed to determine the long-term feasibility, and effects on quality of life and major clinical outcomes, including mortality and cardiovascular risk, in all CKD stages and particularly in kidney transplant patients, a scarcely investigated population. Physical exercise plays a crucial role in ameliorating inflammation, oxidative stress, vascular function, immune response and macromolecular metabolism, and contributes significantly to the quality of life for patients with CKD, irrespective of the treatment and stage. Its direct impact on kidney function remains uncertain. Further extensive, long-term trials to conclusively determine the effect of exercise on major clinical outcomes such as mortality and cardiovascular risk remain a research priority.

The Enablers and Barriers Associated With the Performance of Physical Exercise in Patients with Gestational Diabetes Mellitus

Background: Scientific evidence has shown that ante-natal lifestyle therapies such as physical exercise can enhance pregnancy outcomes and lower the risk of gestational diabetes (GDM). However, more than 60% of women with gestational diabetes do not perform physical exercise and a sedentary lifestyle may heighten the risk of this disease. The purpose of this study was to identify the factors that promote or hinder the performance of physical exercise in patients with gestational diabetes mellitus. Materials and Methods: The study employed a cross sectional design and a purposive sampling technique was used to recruit the respondents. The research instrument was a modified and pre-tested self-administered questionnaire adapted from previous studies. A structured barrier and enabler (BE) questionnaire was used for data collection. Results: All respondents cited lack of time as a barrier, followed by children’s demands (34.2%), laziness (15.8%), being unaccustomed to physical exercise (14.5%), and lack of information (2.6%). On the other hand, 28.9% of the women claimed that social media, 15.8% “being fit”, 15.8% “being healthy”, 7.9% “looking nice” and 2.9% “being active” were their major stimulus or enablers. Conclusion: This study reflects that the value placed on the performance of physical exercise is secondary to cultural demands. While the women in this study viewed physical activity as important for their health, it was usually prioritized behind their demanding roles as mothers, partners and homemakers. Recommendations: Physical Exercise prescriptions should consider the geographic and cultural orientation of the people for effective compliance. Moreover, a public health approach aimed at enlightening the populace of the importance of physical exercise in patients with gestational diabetes mellitus would be of tremendous help at minimizing the barriers and promoting the participation of these categories of patients in the performance of physical exercise.

Gambaran Latihan Fisik pada Pasien Diabetes Mellitus Tipe 2 di Masa Pandemi COVID-19

This study aims to identify physical exercise features in patients with type 2 diabetes mellitus during the COVID-19 pandemic. The research method used is a narrative review by searching articles using Pubmed, Cinahl, and Sage Journals. The results of the study showed that eight pieces reported that there was a decrease in the frequency and intensity of physical exercise in patients with type 2 diabetes during the COVID-19 pandemic, and two articles reported that respondents continued to do physical activity during the COVID-19 pandemic. In conclusion, the frequency of physical activity carried out by people with diabetes during the COVID-19 pandemic has decreased and remained the same. Still, most of them are described as experiencing a decrease in exercise intensity and frequency.
 
 Keywords: Type 2 Diabetes Mellitus, Physical Exercise, COVID-19 Pandemic

#4311 DEVELOPMENT OF A HOME DIALYSIS PATIENT SUPPORT SYSTEM WITH EXERCISE FUNCTION PART II: RESULTS OF A TRIAL OF ADDED EXERCISE FUNCTION

Abstract Background and Aims In Japan, peritoneal dialysis patients are required to record daily dialysis information in continuous ambulatory peritoneal dialysis (CAPD) notes. However, as the CAPD notes are a list of numbers, it is difficult for medical staff to quickly understand the patient's physical condition. Although many people now use communications infrastructure, access to medical information on the Internet is restricted from the viewpoint of patient information security in medical institutions in Japan. Therefore, patient information outside the medical institution cannot be viewed on the system inside the medical institution. Therefore, we are developing a safe and secure dialysis support system to connect dialysis patients’ homes and medical institutions. We have developed a dialysis support system that can share the patient's vital data, dialysis records, meal records, etc., between patients and medical institutions. Here, we added a function to support the exercise of dialysis patients, and present the results of a trial. Method The display and recording items of the previously developed system include vital data, and exchange start time as records necessary for peritoneal dialysis, dialysate concentration, drainage volume, fluid injection volume, drainage volume, drainage time, drainage confirmation, blood pressure, and blood sugar level. In addition to these items, we have added a new function to the system that can automatically input the patient's exercise records from ergo-storage device. This added functionality links movement information from the ergo-storage device with relevant patient information in the previously developed system. It also enables medical staff to view and share the graphical data as visible information from within the facility. The patients exercise using the developed ergo-storage device, and the amount of exercise is stored in the charger. Patients can exercise with this ergo-storage device on both dialysis and non-dialysis days. Results To prevent erroneous input, the dialysis records could be entered automatically or selected using radio buttons. In addition, when confirming drainage, it was possible to transmit images to medical institutions. In the added exercise function, the strength of pedaling on the ergo-storage device, the number of rotations, etc., could be output in CSV format. The amount of exercise was sent to the previously developed system. In addition, the system allowed storage of the electricity generated by rotating the pedals in the storage device. This added exercise function encouraged and sustained exercise in dialysis patients. It not only supported the patient's exercise, but also encouraged continuation by compensation for the amount of exercise via storage of electricity to charge devices. Therefore, the patients were motivated not only to exercise but also to continue to exercise. The accumulation of exercise data enabled the patients to understand changes over time, leading to self-management. Furthermore, exercise could be continued even on non-dialysis days. Medical institutions could also share not only the patient's dialysis records, but also information on their amount of exercise, leading to improved patient care. Conclusion This developed system with new exercise function supported patients’ exercise and its continuation on both dialysis and non-dialysis days. The amount of exercise by the patient was stored as electricity, which could be used to charge the patient's cell phone, etc. This increased the patients’ motivation to exercise. Furthermore, this information can be shared with medical institutions. This research was supported in part by Gakushin Kaken (JP20H03982).

The Pressure Is Rising: Evaluation and Treatment of Chronic Exertional Compartment Syndrome.

Chronic exertional compartment syndrome is a condition that typically affects athletic/active individuals. Chronic exertional compartment syndrome predominantly affects the lower leg; however, there are cases involving the hand, forearm, foot, and thigh. The signs and symptoms of chronic exertional compartment syndrome are severe pain, tightness, cramping, muscle weakness, and paresthesias during participation in exercise. Dynamic intramuscular compartmental pressure (preexertion and postexertion) is the standard diagnostic test. Although other imaging modalities, such as radiography, ultrasound, and magnetic resonance imaging are typically incorporated to rule out other pathologies. In addition, these modalities are being utilized to limit invasiveness of the diagnostic experience. Initial care commonly involves conservative treatment, such as physical therapy, modifications of patient's exercise technique, foot orthoses, and various procedures over a period of 3 to 6 months. Recalcitrant cases may be referred for surgical intervention (fasciotomy), which has inconclusive head-to-head data with conservative management with regard to return to prior sport and specific activity level.

Impact of the COVID-19 pandemic on exercise tolerance and patient outcomes with phase III cardiac rehabilitation in Japan: A multicenter study.

This study aimed to determine how behavioral restrictions due to the emergency declaration following the coronavirus disease 2019 (COVID-19) pandemic affect exercise tolerance and its outcomes in patients in the phase III cardiac rehabilitation program. This is a multicenter retrospective cohort study. Participants in outpatient cardiac rehabilitation programs and cardiopulmonary exercise testing before and after the emergency declarations were included. A total of 90 participants were included (median age 75.0 years, 69% male), and the changes in physical function and exercise tolerance were compared before and after the emergency declaration. Patients were divided into a decline-in-peak oxygen uptake (VO2 ) group and a nondecline-in-peak VO2 group. Comparison before and after the emergency declaration showed that the anaerobic threshold declined significantly and peak VO2 exhibited a downward trend. The decline-in-peak VO2 group consisted of 16 patients (17%) with better exercise tolerance, multiple comorbidities, and declined lower extremity muscle strength. These patients also had a higher rate of subsequent composite events (HR, 5.2; 95% confidence interval, 1.4-18.8, p = 0.01). Before and after the emergency declaration, the patient's exercise tolerance may decline, leading to a poor prognosis. This study suggests the importance of maintaining exercise tolerance during the COVID-19 pandemic. This article is protected by copyright. All rights reserved.

Use of new technologies for the promotion of physical activity in patients with mental illness: A systematic review

Physical exercise is an underutilized tool for the management of mental disorders. New technologies have made a breakthrough in health care, and one of its possible applications (apps) could be that of customizing exercise programs for special populations, such as patients with mental disorders. However, the app of the so-called e-health to mental health care is still limited. To know the efficacy of apps to promote physical activity in patients with mental disorders. We conducted a systematic review of the PubMed and Embase databases with the aim of exploring the use of new technologies for the enhancement of physical exercise in patients with a psychiatric illness. Following the selection process, 10 articles were included in the review. The most commonly used devices in this type of intervention are wearable devices and web platforms. Good results in terms of effectiveness and acceptability were obtained in most of the studies. Our findings suggest that the use of new technologies in mental health represents a feasible strategy with great potential in clinical practice.