Exercise In Patients Research Articles

Relationship between physical exercise and COVID-19 (SARS-CoV-2): systematic review.

The SARS-CoV virus is a precursor to the SARS-CoV-2 virus (COVID-19) and has caused millions of deaths worldwide. Although exercise can be a non-pharmacological means for the prevention and treatment of various diseases, the effects on COVID-19 patients are not yet completely clear. The aim of this study was to investigate the relationship between physical exercise and symptoms caused by COVID-19. The present systematic review was sent for evaluation and received the PROSPERO registration protocol-CRD42021257475. The search for studies related to health and physical exercise was carried out in the following databases; the "National Library in Medicine MEDLINE-Ovid", "Embase", "Web of Science", "SportDiscus-Ebsco", and "Scopus". Ten articles were included in the systematic review and the findings demonstrated the protective effects of physical exercise in patients with COVID-19. These effects were observed both in symptoms and in the period of hospitalization. In addition, the results show that the benefits of physical exercise seem to collaborate both in an individual manner and as an alternative to drug therapy. Finally, it was possible to verify the effect of physical exercise on variables, such as quality of life, cardiorespiratory capacity, and immunological biomarkers, and on the symptoms of the new Coronavirus. It is possible to conclude that physical exercise can be a component for the treatment of COVID-19. In addition, it could help to reduce the symptoms and severity of COVID-19, and may be considered as an adjunct to drug therapy in patients contaminated with SARS-CoV-2.

Effects of Walking as Physical Exercise on Functional Limitation through Pain in Patients with Fibromyalgia-How Does Catastrophic Thinking Contribute?

Background: Aerobic exercise has a beneficial impact on physical and mental health. However, patients with fibromyalgia do not always report perceiving these improvements. Objective: The aim of this study was to examine whether catastrophic thinking moderated the effects of perceived pain severity once an active and regular lifestyle had been established on functional limitation in chronic pain patients, in particular in fibromyalgia patients. Methods: The sample consisted of a total of 491 women with fibromyalgia diagnosed according to the criteria of the American College of Rheumatology. Participants completed an ad-hoc item about lifestyle related to walking pattern, the Brief Pain Inventory, the Pain Catastrophization Scale, and the Fibromyalgia Impact Questionnaire-Revised. To examine the relationship between the variables, a moderate mediation analysis was performed through the macro PROCESS (model 14). Results: The relationship between the performance of the recommended walking pattern and functional limitation was mediated by the severity of pain (B = −5.19, SE = 1.59, t = −3.25, 95% CI = [−4.06, −0.28], p < 0.001). Furthermore, it was found that the mediating effect of pain severity was moderated by catastrophic thinking (Index = −0.014, SE = 0.007, 95% CI [0.002, 0.030]). Conclusions: The positive effect of walking on functionality through the reduction of pain levels is favored when patients present low catastrophizing, which affects the relevance of including interventions focused on the reduction of catastrophizing in the prescription of physical exercise in patients with fibromyalgia as the treatment of choice.

The Potential of Exerkines in Women's COVID-19: A New Idea for a Better and More Accurate Understanding of the Mechanisms behind Physical Exercise.

The benefits of physical exercise are well-known, but there are still many questions regarding COVID-19. Chow et al.'s 2022 study, titled Exerkines and Disease, showed that a special focus on exerkines can help to better understand the underlying mechanisms of physical exercise and disease. Exerkines are a group of promising molecules that may underlie the beneficial effects of physical exercise in diseases. The idea of exerkines is to understand the effects of physical exercise on diseases better. Exerkines have a high potential for the treatment of diseases and, considering that, there is still no study of the importance of exerkines on the most dangerous disease in the world in recent years, COVID-19. This raises the fundamental question of whether exerkines have the potential to manage COVID-19. Most of the studies focused on the general changes in physical exercise in patients with COVID-19, both during the illness and after discharge from the hospital, and did not investigate the basic differences. A unique look at the management of COVID-19 by exerkines, especially in obese and overweight women who experience high severity of COVID-19 and whose recovery period is long after discharge from the hospital, can help to understand the basic mechanisms. In this review, we explore the potential of exerkines in COVID-19 by practicing physical exercise to provide compelling practice recommendations with new insights.

Cardiovascular Disease and its Risk Factors: Frequency in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is one of the respiratory conditions which is indicated by persistent airflow obstruction. It is linked with various different comorbidities. Ischemic heart disease (IHD) is reported to be the most recurring in patients with COPD. Its impact in context of patient's exercise capacity, health status and manifestation of symptoms is poorly understood. The objective of my study is to ascertain the frequency of ischemic heart disease in patients with chronic obstructive pulmonary disease and to evaluate current magnitude of the problem in our local population. It a cross sectional study conducted in Department of Pulmonology, Nishtar Hospital Multan. Patients with COPD (as defined in Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria 2021) with duration of more than 3 months were taken in the study. Of these 212 study cases, 127 (59.9 %) were male patients while 85 (40.1 %) were female patients. Mean age of our study cases was 56.75 ± 6.78 years. Diabetes was present in 57 (26.9 %), Dyslipidemia in 43 (20.3%), hypertension in 98 (46.2%) our patients and 29 (13.7 %) were obese. Smoking was noted in 100 (47.2 %). Ischemic Heart disease was present in 57 (26.9%) of our study cases. High frequency of ischemic heart disease was noted in patients with chronic pulmonary obstructive disease in our study. Ischemic Heart Disease was significantly linked with male gender, increasing age, diabetes, hypertension, obesity, and family history for IHD and dyslipidemia.

Exercise MR-proANP unmasks latent right heart failure in CTEPH

Abstract Background Chronic right heart failure is the major determinant of outcome in chronic thromboembolic pulmonary hypertension (CTEPH). Thus, its early detection is crucial for optimal patient management. Hemodynamic assessment with invasive right heart catheterization and the measurement of natriuretic peptides at rest are established diagnostic tools in this context. An elevated right atrial pressure (RAP) is a sensitive parameter of right right heart failure. Mid-regional pro-atrial natriuretic peptide (MR-proANP) is a natriuretic peptide that reflects right atrial stress levels. There is a growing recognition of exercise diagnostics in the assessment of right heart failure, particularly in patients with normal or borderline findings at rest. There are no data on the dynamics of MR-proANP in correlation to RAP during physical exercise. Purpose The present study was designed to investigate the dynamics of RAP and MR-proANP during physical exercise in patients with CTEPH and to determine whether these parameters might serve as a tool to measure exercise-dependent atrial stress as an indicator of right heart failure. Methods This observational cohort study included 100 CTEPH patients who underwent right heart catheterization during physical exercise (eRHC). Blood samples for MR-proANP measurement were taken prior, during, and after eRHC. MR-proANP levels were correlated to RAP levels at rest, at peak exercise (eRAP), and during recovery. RAP at rest ≤7 mmHg was defined as normal and eRAP &amp;gt;15 mmHg as suggestive of right heart failure. Results During eRHC mean RAP increased from 6±4 mmHg to 16±7 mmHg (p&amp;lt;0.001). MR-proANP levels and dynamics correlated with RAP at rest (rs=0.61; p&amp;lt;0.001; figure 1a) and at peak exercise (rs=0.66; p&amp;lt;0.001; Figure 1b). Furthermore, the relative percent increase in MR-proANP correlated with the relative percent increase in eRAP (rs=0.52; p&amp;lt;0.001; Figure 1c) Logistic regression analysis revealed the peak MR-proANP level (B=0.058; p=0.004) and the right atrial area (B=0.389; p&amp;lt;0.001) to be associated with eRAP dynamics. A peak MR-proANP level ≥139 pmol/L (AUC=0.81) and recovery level ≥159 pmol/L (AUC=0.82) predicted an eRAP &amp;gt;15 mmHg. Physical exercise unmasked RH failure in 39% of patients with normal RAP at rest; they were also characterized by a more distinct increase in MR-proANP levels (p=0.005) and higher peak (p&amp;lt;0.001) and recovery levels (p&amp;lt;0.001). Conclusions RAP and MR-proANP dynamics unmask manifest and latent right heart failure in CTEPH patients, which may be useful in estimating prognosis. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): SFB 1213 area CP-01 projectWilliam G. Kerckhoff-FoundationKerckhoff Heart Research Institute (KHFI)German Center for Cardiovascular Research (DZHK)

Integrating molecular biomarkers in breast cancer rehabilitation. What is the current evidence? A systematic review of randomized controlled trials.

Background: Quality of life issues is a crucial burden in breast cancer (BC) survivors with relevant implications in terms of survivorship and health-care costs. The increasing long-term survival of these patients provides new challenges, with translational research now focusing on innovative and tailored approaches to improve their complex management. In this scenario, several emerging biomarkers have the potential to improve the clinical rehabilitative management of patients with BC. However, to date, guidelines supporting biomarker implementation in this area are still lacking. Therefore, the aim of this systematic review was to summarize the currently available biomarkers that might be potentially integrated into rehabilitation practice to promote a precision medicine approach to BC survivorship issues. Methods: On 9th March 2022, PubMed, Scopus, Web of Science, Cochrane, and PEDro were systematically searched for randomized controlled trials (RCTs) assessing rehabilitation interventions in BC patients. Molecular biomarker modifications induced by physical exercise have been assessed through the review of the study protocols and published results. The Jadad scale was used to assess the quality of the studies included. Results: Out of 2,224 records, 22 studies were included in the present systematic review. Exercise therapy showed significant results in 15 RCTs, in terms of metabolic biomarkers, including glycemic and insulin profile, and lipid profile (p ≤ 0.05). Similarly, 12 studies underlined significant effects in inflammation and immune response biomarkers, including TNF-α, IL-6, IL-10, C-reactive protein, leptin, and adiponectin (p ≤ 0.05). On the other hand, cardiac biomarkers were assessed in three studies without reporting significant differences after exercise therapy (p = NS). The quality assessment identified 19 RCTs as high-quality studies and three RCTs of low quality. Conclusion: Our findings reveal significant biochemical perturbations in key molecules induced by physical exercise in patients with BC, suggesting room for the implementation of actionable biomarkers. Future research might clarify the role of biomarkers on treatment effectiveness monitoring, to optimize rehabilitative strategies tailored to patient’s needs.

Effectiveness of Yoga-based Interventions on Chronic Low Back Pain (CLBP) – A Review of Randomized Controlled Trials

Low back pain (LBP) is defined as the pain and stiffness above the inferior gluteal folds and below the costal margin. The LBP lasting for the duration of 12 weeks or more is considered chronic low back pain (CLBP). The age-standardized incidence rate of LBP observed in South Asia was 2,362.13 per 100,000 population. The global incidence of LBP increased by 50%, from 149,294,134.47 to 223,455,640.82 cases from 1990 to 2019 respectively. Studies reported that the yoga-based interventions reduces disability, pain, pain medicine, stress, anxiety, depression and negative emotions, and improves spinal flexibility, quality of life and positive emotions in patients with CLBP more effectively than usual care and physical exercise. Yoga appeared to be more effective than physical exercise in patients with CLBP which may be because of various aspects of yoga, such as maintaining the yoga postures, breath regulation, mindfulness, meditation, relaxation etc. which separated yoga from physical exercises. It is suggested that the government and public hospitals should take actions to employ the ancient science of yoga to cure the patients with CLBP to avoid side effects and complications.

Can the Combination of Rehabilitation and Vitamin D Supplementation Improve Fibromyalgia Symptoms at All Ages?

Several studies have indicated a correlation between vitamin D deficiency and widespread chronic pain syndromes, such as fibromyalgia. During this study, the effect of supplementation with vitamin D in association with physical exercise in patients with fibromyalgia was evaluated, in terms of improvement of pain, functional capacity and quality of life, also evaluating the presence of any differences in age. A single-center, observational, comparative study was conducted in 80 fibromyalgia patients. They are randomized into 2 groups: Group A, consisting of patients ≤50 years; and group B, consisting of patients >50 years. Both received weekly supplementation with 50,000 IU cholecalciferol for 3 months in association with a rehabilitation protocol. Patients were assessed at enrollment (T0), 3 months (T1), and 6 months (T2) from the initial assessment with blood vitamin D dosage and administration of rating scales (NRS, FIQ, and SF-12). From the comparison between the two groups, we have seen that in young people, supplementation with high-dose vitamin D improves short-term musculoskeletal pain and long-term functional capacity. Conversely, musculoskeletal pain and long-term quality of life improve in the elderly. Supplementing with high doses of vitamin D in fibromyalgia patients improves the quality of life and pain in the elderly and also the functional capacity in the young.

Hospital Intervention to Reduce Overweight with Educational Reinforcement after Discharge: A Multicenter Randomized Clinical Trial.

Introduction: Obesity and overweight affect more than one-third of the world’s population and pose a major public health problem. Objective: To evaluate the impact of an educational intervention on dietary habits and physical exercise in patients with overweight admitted to departments of internal medicine, comprising a pre-discharge educational session with follow-up and reinforcement by telephone at 3, 6, and, 12 months post-discharge. Outcome variables were weight, systolic (SBP) and diastolic (DBP) blood pressures, health-related quality of life (HRQOL), hospital readmissions, emergency department visits, and death. Method: A randomized experimental study with a control group was performed in hospitalized non-diabetic adults aged ≥18 years with body mass index (BMI) ≥25 Kg/m2. Results and conclusions: The final sample included 273 patients. At three months post-discharge, the intervention group had lower SBP and DPB and improved dietary habits (assessed using the Pardo Questionnaire) and VAS-assessed HRQOL in comparison to the control group but a worse EQ-5Q-5L-assessed HRQOL. There were no between-group differences in hospital readmissions, emergency department visits, or mortality at any time point. Both groups evidenced a progressive improvement over the three follow-up periods in weight, SBP, and dietary habits but a worsening of EQ-5D-5L-value-assessed HRQOL. Discussion: The intervention group showed greater improvements over the short term, but between-group differences disappeared at 6 and 12 months. Weight loss and improvements in key outcomes were observed in both groups over the follow-up period. Further research is warranted to determine whether a minimum intervention with an educational leaflet, follow-up phone calls, and questionnaires on overweight-related healthy habits, as in the present control group, may be an equally effective strategy without specific individual educational input.

Effect of Routine Therapy Assisted by Physical Exercise on Pulmonary Function in Patients with Asthma in Stable Stage: A Systematic Review and Meta-analysis of Randomized Clinical Trials.

Objective This study is aimed at investigating the efficacy of physical exercise-assisted routine therapy on the pulmonary function of patients with stable asthma to provide clinical evidence and data support to guide disease management. Methods Randomized controlled clinical trials of drug therapy and/or physical exercise for patients with stable asthma were retrieved from the China National Knowledge Infrastructure (CNKI), Wanfang database, Embase, PubMed, and Web of Science database. The studies published between January 2000 and June 2021 that met the criteria were included, and corresponding data were extracted. The meta-analysis was performed using the statistical software Stata 16.0. Statistical pooled effect sizes and 95% confidence intervals were calculated using a random-effects or fixed-effects model, as funnel plots were made with Begg's rank correlation method to evaluate publication bias. Result This meta-analysis included 14 randomized controlled studies. Physical exercise-assisted treatment (experiment group) or routine therapy was associated with significantly elevated levels of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) (P < 0.05). As for the peak expiratory flow (PEF) level (P < 0.05), its level was significantly increased with physical exercise-assisted therapy compared with the conventional approach (P > 0.05). Subgroup analysis indicated that the FVC level in the experimental group was higher than that in the control group (P < 0.05) regardless of the adoption of aerobic exercise/anaerobic exercise. In regard to the FEV1 and PEE levels, aerobic exercise was associated with elevated levels in the experimental group (P < 0.05), while no significant difference in anaerobic exercise between both groups was observed (P > 0.05). Further, FEV1, FVC, and PEF levels in the experimental group were higher than those receiving conventional treatment in the control group (P < 0.05). Conclusion Routine treatment combined with physical exercise could improve the levels of FEV1, FVC, and PEF in patients with bronchial asthma in the nonacute attack stage and enhance pulmonary functions. As a safe and efficient adjuvant therapy, physical exercise can contribute to an improved prognosis and quality of life for patients with asthma.

Types of exercise and the relationship between body image dissatisfaction and compulsive exercise behaviors.

Body image dissatisfaction and compulsive exercise behaviors are two main factors in recognizing an eating disorder within active individuals. By examining types of exercise and trends within the general population, it may provide insight into how exercise plays a role in eating disorder symptoms and other mental health concerns. We employed a cross-sectional study to examine our patient's exercise behaviors, compulsive exercise traits, and body image dissatisfaction. A total of 96 (35 males, 61 females) physically active adults (m<inf>males</inf> 26.2±4.47 years, m<inf>females</inf> 25.6±5.13 years) completed a survey that included a modified version of the Body Image Concern subscale of the Body Change Questionnaire (BCQ) and the Obligatory Exercise Questionnaire (OEQ). The average scores between males and females on the BCQ and OEQ were not statistically different from one another. Strength and aerobic training did not correlate with BCQ scores. There was no correlation between OEQ scores and any of the three exercise methods. A positive correlation existed between OEQ scores and the frequency of workouts per week (r=0.568, P<0.001). Only females demonstrated negative correlations between BCQ scores and mixed-method training (r=-2.54, P=0.049) and between BCQ scores and the frequency of workouts per week (r=-2.57, P=0.046). Our findings demonstrate the importance of addressing body image dissatisfaction for all populations, regardless of gender. Athletic trainers can utilize mixed-method training to help at-risk individuals train without increasing their body dissatisfaction symptoms.

Exploiting exercise electrocardiography to improve early diagnosis of atrial fibrillation with deep learning neural networks

Atrial fibrillation (AF) is the most common type of sustained arrhythmia. It results from abnormal irregularities in the electrical performance of the atria, and may cause heart thrombosis, stroke, arterial disease, thromboembolism, and heart failure. Prior to the onset of atrial fibrillation, most people experience atrial cardiomyopathy which, if effectively managed, can be prevented from progressing to atrial fibrillation. Electrocardiogram (ECG) can show changes in the heartbeats, and is a common and painless tool to detect heart problems. P-waves in exercise ECGs change more drastically than those in regular ECG, and are more effective in the detection of atrial myocardial diseases. In this paper, we propose a deep learning system to help clinicians to early detect if a patient has atrial enlargement or fibrillation. Firstly, a Convolutional Recurrent Neural Network is employed to locate the P-waves in the patient's exercise ECGs taken in the exercise ECG test process. Relevant parameters are then calculated from the located P-waves. Then a Parallel Bi-directional Long Short-Term Memory Network is applied to analyze the obtained parameters and make a diagnosis for the patient. With our proposed deep learning system, the changes of P-waves collected in different phases in the exercise ECG test can be analyzed simultaneously to get more stable and accurate results. The system can take data of different length as input, and is also applicable to any number of ECG collections. We conduct various experiments to show the effectiveness of our proposed system. We also show that the more ECG data collected in the exercise phase are involved, the more effective our system is in diagnosis of the diseases.

MO1053: Development of Home Dialysis Patient Support System Using Cloud System I––System Development and Evaluation

BACKGROUND AND AIMSDue to COVID-19 and the aging of the Japanese population, it is becoming increasingly difficult for patients to travel to medical facilities. Although the utilization rate of communication networks and devices for the elderly is low, many people of all ages are now using the Internet. However, in Japan, there are no computer systems that directly connect medical institutions and people’s homes because of the restricted connection of medical institutions to the Internet. Therefore, the utilization rate of the medical support system for home-based patients using the Internet is not high. We have been developing a remote medical support system for home-based patients that is both safe and secure. Here, we focused on exercise support for dialysis patients at home, and developed and evaluated a dialysis patient exercise support system that can efficiently share information between patients and medical facilities regardless of where and when dialysis or exercise is performed.METHODA system for sharing medical information was developed in the PHP programming language to use the Microsoft Azure cloud service. Figure 1 shows a schematic diagram of the developed system. All patient record data can be entered via drop-down menus. In addition, drainage packs and meal menus can be registered as images of up to 3 MB in size in the developed system. Pedaling exercise was added to this system. Patients used an ergometer to perform pedaling exercises, which allowed the amount of pedaling to be automatically entered into the system. A dynamo was connected to the ergometer to store electricity, which could be used to charge mobile devices and promote continuous exercise. The developed system was evaluated by volunteers, consisting of 12 females and 4 males in their 20s, 2 males in their 30s, 1 female and 1 male in their 40s and 1 female and 2 males in their 50s. Web usability was assessed by task execution rate and the website usability scale (WUS). Data were captured directly from the ergometer into records of the patient's exercises.RESULTSThe developed system allows medical professionals to view patient biometric data. The patients exercised with an ergometer, and the exercise data were automatically imported from the ergometer directly into the developed system in CSV format via e-mail. The amount of exercise could also be entered manually using the drop-down menus. These numerical data could also be displayed as a graph, thus making it possible to visually capture changes over time. In addition, as the amount of electricity obtained from exercise can be stored, it can be used to charge mobile devices. There was no erroneous input because there was no keyboard input for data entry, and the subjects’ task completion rate was 100%. The system developed in this study can also be used by patients who are unfamiliar with personal computers. The second use of the developed system was easier than the first, and the evaluation of the patients was high. According to the WUS evaluation results in Figure 2f, the item with the greatest difference according to age group was ‘display’. The highest rated item was ‘response’. The average total evaluation for all age groups was ∼3.5, so further improvements are required for the display in the developed system.CONCLUSIONWe have added a function to encourage continuous exercise using an ergometer to our support system for home dialysis patients. The developed system not only allows home-based patient dialysis information to be input, output and displayed without errors, but also allows healthcare professionals to remotely check the data using graphs and photographs. In addition, it was possible to convert the exercise performed by the patient into electrical power that could be used to charge mobile devices, thus supporting the continuation of exercise for dialysis patients. This research was supported in part by Gakushin Kaken (JP18K19710, JP20H03982).

MO1054: Development of Home Dialysis Patient Support System Using Cloud System II––Addition of Exercise Therapy Function

BACKGROUND AND AIMSThe number of patients requiring home dialysis in Japan is increasing due to COVID-19 and the aging of the population. Home haemodialysis has been performed in Japan since the 1960s. However, as of March 2019, there were 720 home haemodialysis patients in Japan, which is only 0.2% of the total number of dialysis patients. The possible causes are as follows.The number of home haemodialysis patients has not increased markedly due to safety concerns as home haemodialysis patients perform dialysis at home, and the out-of-pocket costs are high. In addition, patients and caregivers must be able to manage themselves, and the burden on both patients and caregivers is heavy. Therefore, the Ministry of Health, Labour and Welfare (Japan) has advocated the need for home patients to share information with medical institutions to improve their quality of life, including COVID-19 measures. We have built a system to support home dialysis patients. Here, we have added an exercise therapy function to this system to encourage patients to continue exercising.METHOD The items recorded/displayed in the patient's home peritoneal dialysis support system included records such as time, blood pressure, blood glucose level, urine volume, meal content, replacement start time, dialysate/plasma ratio, drainage volume, injection volume, water content and water removal and drainage. These inputs were entered via drop-down menus and displayed visually in graphs or by uploading images. The medical staff could see photographs of the affected areas and of meals entered by the patient. Patients could also share their opinions and treatment schedules with the medical staff at the medical institution. In addition, when exercising, the patients used an ergometer that allowed them to sit or lie down. The developed system incorporates records of the patient's exercises. Data were captured directly from the ergometer into the developed system in CSV format and could also be entered manually via drop-down menus.RESULTSUsing the developed system, we were able to enter and view patients’ vital data and display photographs showing the color and volume of the drainage pack. By viewing these photographs, the medical staff could confirm the photographs of the affected areas, the color of the packs and the contents of the patients’ meals. In addition, displaying the patient's vital records in a graph allowed for visual evaluation over time, which was useful when giving advice to patients. Using the two-way communication function, patients were also able to share their opinions and treatment schedules with the medical staff of the medical institution. Patients can now consult with medical staff, making their homes more like part of the hospital and giving them greater peace of mind.Figure 1 shows an example of the display of the developed system. Figure 2 shows an example of the patient's pedaling exercise results input from the ergometer. The amount of pedal movement performed by the patient was conserved through the dynamo and used to charge mobile devices. This allows the patient to charge their mobile devices while exercising, thus encouraging them to continue exercising.CONCLUSION We have developed a support system for home haemodialysis patients that allows the input and display of patients’ vital records and consultation with medical staff online. We have added a function to the system to encourage home haemodialysis patients to continue exercising. By using the developed system, patients can now perform home dialysis, including continuous exercise safely and with peace of mind, and healthcare professionals can access all medical information of patients, including changes over time.This research was supported in part by Gakushin Kaken (JP18K19710, JP20H03982).

A five-year follow-up report on lung imaging and exercise endurance of a patient with paraquat poisoning

A patient with paraquat poisoning was followed up for five years, and it was showed that the interstitial lesion areas in chest CT of this patient gradually decreased after acute period of the poisoning and no significant changes were found six months later. After that the density of the lesions gradually reduced, while the cystic air cavities slowly increased. In addition, the patient's exercise endurance gradually improved over time, and the lung function was close to the normal level five years after poisoning. The follow-up report helps clinicians to have a deeper understanding of the long-term outcome of paraquat poisoning.

Quand bouger n’est plus synonyme de santé : une recension des traitements de l’exercice physique pathologique en troubles des conduites alimentaires

IntroductionPathological physical exercise is a central feature of eating disorder and is related to a poor prognosis. Only few evidence-based recommendations are currently available to guide caregivers in the management of “exerciser” patients. Objective. The purpose of this paper is to present the current state of knowledge regarding proposed treatments targeting specifically the management of pathological physical exercise in patients with any type of eating disorder. MethodThe literature search took place in March 2020 and has been updated in February 2021 in databases (PsycINFO, PubMed, MEDLINE, SPORTDiscuss, etc.). English keywords encompassing concepts associated with pathological physical exercise, any type of eating disorder, and treatment were used in various combinations. To be included in the study, the publications identified must be written in English or French and be quantitative or qualitative empirical articles, systematic reviews of the literature or meta-analyses, case studies or syntheses of clinical guidelines. ResultsThe synthesis of the studies highlights four main classes of pathological physical exercise treatment: adapted physical exercise treatment (n=6), cognitive-behavioral therapy (n=4), thermoregulation (n=1) and pharmacotherapy (n=1). The summary of currently available treatments for pathological exercise indicates benefits of adapted physical exercise and cognitive-behavioral therapy treatments, primarily. These treatments demonstrate efficacy in improving principally the qualitative components of pathological exercise (decrease of compulsion towards exercise, dysfunctional attitude towards exercise, rigidity towards exercise, exercise to regulate emotions and lack of pleasure during exercise and rule-based exercise) in addition to a favorable effect on other symptoms associated with eating disorder (increase of the body mass index, quality of life, motivational change stage and emotional acceptance as well as decrease of the global eating disorder severity, drive for thinness, perfectionism, depression symptoms and psychological distress). Treatments aimed at reducing pathological exercise should include adapted physical exercise combined with cognitive-behavioral therapy principles, principally. Also, pathological physical exercise treatment should (1) promote the benefit of group and pleasure to avoid ascetic and compulsive behaviors as well as provide a variety of movement, (2) include relaxation/rest intervals to reconnect with bodily sensations, (3) include psychoeducational interventions to learn to identify pathological physical exercise and (4) address emotions and cognitions related to exercise to change the function of behavior. Pharmacological treatments should be used only in specific cases and with great caution. ConclusionWhile this review points to a predominantly uni- or multi-disciplinary approach to the management of pathological physical exercise, the multidimensionality and complexity of this phenomenon dictates that it be managed holistically through a transdisciplinary team. In this regard, transdisciplinary programs that consider physical exercise as a complex phenomenon transcending sectors of activity must be seriously considered.

The effectiveness of physical exercise in patients with lumbar spinal stenosis: a systematic review

The effectiveness of physical exercise in patients with lumbar spinal stenosis: a systematic review

A Mixed Comparisons of Aerobic Training With Different Volumes and Intensities of Physical Exercise in Patients With Hypertension: A Systematic Review and Network Meta-Analysis.

It is essential for patients with hypertension to effectively reduce and maintain appropriate blood pressure levels. As one of the non-pharmacological and invasive methods, physical exercise seems to improve blood pressure of the patients with hypertension. However, different volumes and intensities of physical exercise on the improvement of hypertension are different. To understand the effects of the type of exercise training on blood pressure and the other health status of patients with hypertension, a network meta-analysis was used to compare the mixed effects of different types of exercise training. This systematic review includes all eligible randomized controlled trials of PubMed, Medline, Cochrane Library, and CINAHL. Twelve studies met the inclusion criteria (n = 846 participants at the end of the study). The results show that a medium-intensity training (MIT) is best in improving the blood pressure of patients with hypertension, while a high-volume high-intensity interval training (HVHIIT) is better in reducing body mass and resting heart rate. In addition, the analysis of the exercise capacity shows that HVHIIT has a better effect on the improvement of patients with hypertension. Noticeably, long-term high-volume and appropriate intensity exercise can effectively improve the health status of patients with hypertension. In short, for patients with high blood pressure, MIT seems to be better at lowering blood pressure, while HVHIIT can better improve exercise ability and physical fitness. However, larger randomized controlled trials with a longer duration than those included in this meta-analysis are needed to confirm these results.

Impact of Cancer Cachexia on Cardiac and Skeletal Muscle: Role of Exercise Training.

Simple SummaryCachexia is a syndrome that can be present in many patients diagnosed with cancer, especially in those with metastatic or very advanced tumors. The patient may present with weight loss, loss of muscle mass, and even cardiac dysfunction as a result of it. The aim of this review is to understand how cachexia manifests and whether physical exercise has any role in trying to prevent or reverse this syndrome in cancer patients.Cachexia is a multifactorial syndrome that presents with, among other characteristics, progressive loss of muscle mass and anti-cardiac remodeling effect that may lead to heart failure. This condition affects about 80% of patients with advanced cancer and contributes to worsening patients’ tolerance to anticancer treatments and to their premature death. Its pathogenesis involves an imbalance in metabolic homeostasis, with increased catabolism and inflammatory cytokines levels, leading to proteolysis and lipolysis, with insufficient food intake. A multimodal approach is indicated for patients with cachexia, with the aim of reducing the speed of muscle wasting and improving their quality of life, which may include nutritional, physical, pharmacologic, and psychological support. This review aims to outline the mechanisms of muscle loss, as well as to evaluate the current clinical evidence of the use of physical exercise in patients with cachexia.

Physical Exercise in People with Chronic Kidney Disease-Practices and Perception of the Knowledge of Health Professionals and Physical Activity and Sport Science Professionals about Their Prescription.

There is evidence on the need to include physical exercise as a treatment for diseases. A large number of professionals are involved in this, but it is not known how physical exercise is prescribed and which professionals are involved. This research has two objectives: (a) to find out the current practices in Spain regarding the prescription of physical exercise in patients with Chronic Kidney Disease (CKD) and (b) to analyse the perception that different health and physical activity professionals have of their knowledge to prescribe of physical exercise in the treatment of CKD. This is an empirical research with an ex post facto retrospective analysis of the information in a descriptive and correlational way. A total of 692 health and sports professionals participated. A questionnaire validated by a committee of experts was administered. Descriptive analyses were carried out and the differences in the study variables were analysed using Chi-square tests and one-factor Analysis of Variance. From the results obtained, we conclude there is a need to develop specific training programmes in the field of physical exercise for health professionals, as well as the establishment of multiprofessional teams for the prescription of physical exercise in CKD treatment, including physical exercise professionals (Cafyde).