Routine Physical Activities Research Articles

Age-Related Changes in the Global DNA Methylation Profile of Leukocytes Are Linked to Nutrition but Are Not Associated with the MTHFR C677T Genotype or to Functional Capacities

Global DNA methylation of peripheral blood leukocytes has been recently proposed as a potential biomarker for disease risk. However, the amplitude of the changes in DNA methylation associated with normal aging and the impacts of environmental changes on this variation are still unclear. In this context, we evaluated the association of global DNA methylation with nutritional habits, tobacco smoking, body mass index (BMI), clinical laboratory parameters, polymorphism C677T MTHFR, functional cognition and the daily practice of physical activity in a cancer-free older population. Leukocyte global DNA methylation from 126 older individuals was quantified using a high-throughput ELISA-based method. Global DNA hypomethylation was observed in older individuals when compared to a younger population (p = 0.0469), confirming changes in DNA methylation in the aging process. Furthermore, the methylation profile of elders was correlated with the daily ingestion of carbohydrates (p = 0.0494), lipids (p = 0.0494), vitamin B6 (p = 0.0421), magnesium (p = 0.0302), and also to the serum levels of total protein (p = 0.0004), alpha 2 globulin (p = 0.0013) and albumin (p = 0.0015). No statistically significant difference was observed when global DNA methylation were stratified according to C677T MTHFR genotypes (p = 0.7200), BMI (p = 0.1170), smoking habit (p = 0.4382), physical activity in daily life (p = 0.8492), scored cognitive function (p = 0.7229) or depression state (p = 0.8301). Our data indicate that age-related variations in the global DNA methylation profile of leukocytes might be modulated by the daily intake of carbohydrates, lipids, vitamin B6, and magnesium and be associated with serum protein levels, however it is independent of C677T MTHFR genotype and not correlated with BMI, smoking habit, cognitive function or the routine physical activities.

Doit-on continuer à indiquer le Glucantime® en première intention pour le traitement des leishmanioses cutanées en Tunisie ?

A large proportion of the health woes beleaguering modern cultures are because of daily physical activity patterns that are profoundly different from those for which we are genetically adapted. The ancestral natural environment in which our current genome was forged via natural selection called for a large amount of daily energy expenditure on a variety of physical movements. Our genes that were selected for in this arduous and demanding natural milieu enabled our ancestors to survive and thrive, leading to a very vigorous lifestyle. This abrupt (by evolutionary time frames) change from a very physically demanding lifestyle in natural outdoor settings to an inactive indoor lifestyle is at the origin of many of the widespread chronic diseases that are endemic in our modern society. The logical answer is to replicate the native human activity pattern to the extent that this is achievable and practical. Recommendations for exercise mode, duration, intensity, and frequency are outlined with a focus on simulating the routine physical activities of our ancient hunter-gatherer ancestors whose genome we still largely share today. In a typical inactive person, this type of daily physical activity will optimize gene expression and help to confer the robust health that was enjoyed by hunter-gatherers in the wild.

Combined Aerobic and Resistance Exercise Program Improves Task Performance in Patients With Heart Failure

Gary RA, Cress ME, Higgins MK, Smith AL, Dunbar SB. Combined aerobic and resistance exercise program improves task performance in patients with heart failure. Objectives To assess the effects of a home-based aerobic and resistance training program on the physical function of adults with New York Heart Association (NYHA) class II and III patients and systolic heart failure (HF). Design Randomized controlled trial. Setting Home based. Participants Stable patients (N=24; mean age, 60±10y; left ventricular ejection fraction, 25%±9%; 50% white; 50% women) with New York Heart Association (NYHA) classes II and III (NYHA class III, 58%) systolic heart failure (HF). Intervention A 12-week progressive home-based program of moderate-intensity aerobic and resistance exercise. Attention control wait list participants performed light stretching and flexibility exercises. Main Outcome Measures A 10-item performance-based physical function measure, the Continuous Scale Physical Functional Performance test (CS-PFP10), was the major outcome variable and included specific physical activities measured in time to complete a task, weight carried during a task, and distance walked. Other measures included muscle strength, HRQOL (Minnesota Living With Heart Failure Questionnaire, Epworth Sleepiness Scale), functional capacity (Duke Activity Status Index), and disease severity (brain natriuretic peptide) levels. Results After the exercise intervention, 9 of 10 specific task activities were performed more rapidly, with increased weight carried by exercise participants compared with the attention control wait list group. Exercise participants also showed significant improvements in CS-PFP10 total score ( P<.025), upper and lower muscle strength, and HRQOL ( P<.001) compared with the attention control wait list group. Adherence rates were 83% and 99% for the aerobic and resistance training, respectively. Conclusions Patients with stable HF who participate in a moderate-intensity combined aerobic and resistance exercise program may improve performance of routine physical activities of daily living by using a home-based exercise approach. Performance-based measures such as the CS-PFP10 may provide additional insights into physical function in patients with HF that more commonly used exercise tests may not identify. Early detection of subtle changes that may signal declining physical function that are amenable to intervention potentially may slow further loss of function in this patient population.

Exercise Like a Hunter-Gatherer: A Prescription for Organic Physical Fitness

A large proportion of the health woes beleaguering modern cultures are because of daily physical activity patterns that are profoundly different from those for which we are genetically adapted. The ancestral natural environment in which our current genome was forged via natural selection called for a large amount of daily energy expenditure on a variety of physical movements. Our genes that were selected for in this arduous and demanding natural milieu enabled our ancestors to survive and thrive, leading to a very vigorous lifestyle. This abrupt (by evolutionary time frames) change from a very physically demanding lifestyle in natural outdoor settings to an inactive indoor lifestyle is at the origin of many of the widespread chronic diseases that are endemic in our modern society. The logical answer is to replicate the native human activity pattern to the extent that this is achievable and practical. Recommendations for exercise mode, duration, intensity, and frequency are outlined with a focus on simulating the routine physical activities of our ancient hunter-gatherer ancestors whose genome we still largely share today. In a typical inactive person, this type of daily physical activity will optimize gene expression and help to confer the robust health that was enjoyed by hunter-gatherers in the wild.

Wczesna Rehabilitacja Chorych Hospitalizowanych z Powodu Zaostrzenia POChP

Recovery of lung function is delayed by up to two months following acute exacerbation (AE) of COPD patients. After AE, even with optimal medical therapy, it takes a considerable time for COPD patients to recover to baseline ability to perform routine physical activities. Although pulmonary rehabilitation (PR) has long been considered a useful non-pharmacological therapy in stable COPD individuals, there have been only a few studies into the effects of rehabilitation during and/or just after AE. This review updates the application of early PR and main physical therapies both during hospital acute care and following discharge of COPD patients who have experienced exacerbation. It is only recently that literature has demonstrated the feasibility and effectiveness of early PR in COPD patients undergoing AE. Nonetheless, early PR clearly appears to be a treatment indicated just after, or even during, an acute episode in hospital. Future studies should be able to clarify the practical role and effects of a timely application of rehabilitation to acute COPD, as well as the preferred modalities, duration and techniques to apply in this condition.

Risk of injury according to participation in specific physical activities: a 6-year follow-up of 14 356 participants of the SUN cohort

Physical activity is generally accepted as a healthy habit. Nevertheless, its associated risk to cause injuries has not been sufficiently evaluated. Measuring this risk more precisely would contribute to giving more accurate health advice to the general population. Data are from participants (60% women, mean age 38 years) in a cohort of university graduates in Spain (1999-2008). Among other exposures and outcomes, they self report on frequency of participation in several physical activities over 1 year, and on incidence of sports-related injuries after 2, 4 or 6 years follow-up. Participation in 17 physical activities was categorized as a dichotomous variable (yes/no) and also according to average time per week spent in each one. Proportional hazards regression was used to estimate the adjusted relative risks [hazard ratios (HRs)] of incident injury associated with each specific physical activity or with total weekly energy expenditure in leisure-time activity [metabolic equivalents (METs)-h/week]. Statistical analyses were stratified by sex. We identified 1658 incident sports-related injuries among 14 356 participants after a median follow-up of 4.6 years. When we adjusted for overall energy expenditure (METs-h/week) in other activities, age and body mass index (BMI), a higher risk of injury was associated with participation in soccer, other team sports, skiing, tennis, running and athletics (HRs ranging from 1.50 to 1.86) among men. With the exception of soccer (rarely practiced by women in Spain), similar results were found for women (HRs ranging from 1.61 to 2.04). Walking, gymnastics, swimming, mountain hiking and gardening were associated with a low injury risk. Despite the healthy effects of physical activity, we consider that the higher risk for injuries related to soccer, team sports, skiing, tennis, running or athletics should be taken into consideration when advice for more physical activity is given to the general population. Daily routine physical activities such as walking or gardening should be encouraged.

Tension-type headache

Tension-type headache (TTH) is the most prevalent of all headaches and also represents one of the most expensive clinical conditions for the health system. Despite the high impact of this disorder and the existence of well-established diagnostic criteria, knowledge about TTH is still quite limited. In most cases in which crises are quite sporadic, the patients call this normal headache. However, there is a group of patients with the chronic subtype of this headache whose quality of life is greatly compromised. According to the second edition of the International Classification of Headache Disorders, TTH is a bilateral headache of the tight band of pressure type of mild-to-moderate intensity that does not worsen with routine physical activities and whose associated symptoms are less intense than those observed in migraine. Its physiopathology still awaits better elucidation but the existence of central and peripheral mechanisms is already recognized. From a therapeutic viewpoint, simple analgesics are used for the acute treatment of the condition, and tricyclic antidepressants are the most effective class of drugs for its prevention. Follow-up of these patients over the years has demonstrated that the course of TTH is quite favorable in most cases.

The Effects of Anthropometrics, Lifting Strength, and Physical Activities in Disc Degeneration

A cross-sectional study design was used. The objective was to examine the influences of body anthropometrics, axial disc area, and lifting strength on disc degeneration and to compare these with the effects of lifetime physical demands and age. Although recent studies have shown that heredity is a dominant factor in disc degeneration, the common notion that occupational physical loading is the major risk factor persists. However, substantial variations in disc degeneration, particularly at the lowest lumbar levels, remain unexplained by heredity or occupational physical demands. Univariate methods and stepwise multiple regression modeling were used to estimate associations of body height, weight, fat content, axial disc area, isokinetic lifting performance, and lifetime routine physical activities at work and leisure with disc height narrowing and disc signal (in T2 images) based on lumbar MRIs. These data were available from a population sample of 600 men, 35 to 70 years of age. Lower disc signal, representing disc desiccation, was associated with higher age, lower body mass and lifting strength, and larger axial disc area. Of the variance in disc signal, age explained 8.0% (P < 0.001) and body weight/axial disc area, isokinetic lifting strength, and occupational lifting history added 3.9%, 2.3%, and 1.3%, respectively. Greater disc narrowing was associated with higher age, larger axial disc area, and higher occupational physical loading. Of the variance in disc narrowing, age accounted for 3.8% (P < 0.001); axial disc area and occupational loading added 1.9% (P < 0.004) and 1.3% (P < 0.007), respectively. Body weight, lifting strength, and axial disc area were more highly associated with disc degeneration than occupational and leisure physical activity histories, although all had modest influences. Furthermore, higher body mass, greater lifting strength, and heavier work were all associated with more disc height narrowing but less disc desiccation contrary to current views. Smaller discs appeared to have beneficial effects.

Caso 6/2005 - Cavopulmonar total extracardíaco com homoenxerto criopreservado

CLINICAL DATA We report on a 23-year-old male patient who had suffered from cyanosis since birth. In the first year of life he was submitted to a hemodynamics examination and complex heart disease was diagnosed which was clinically accompanied without the use of medications. The patient suffered no limitations in respect to routine physical activities and was in functional class I (NYHA). In the six months previous to arriving in our department, the patient evidenced sudden episodes of dizziness together with dyspnea. He was in a good general state, eupneic at rest but cyanotic 4+/6. The thorax was symmetrical the heart rhythm regular with a single second click, hyperphonic at a pulmonary focus (4+/6) and ejective at a high sternal border. The pulmonary auscultation was symmetrical without adventitious sounds. The abdomen presented with no changes. The pulses were palpable for the four limbs without pressure differences or presence of digital clubbing.

Osteopontin Gene Regulation by Oscillatory Fluid Flow via Intracellular Calcium Mobilization and Activation of Mitogen-activated Protein Kinase in MC3T3–E1 Osteoblasts

Recently fluid flow has been shown to be a potent physical stimulus in the regulation of bone cell metabolism. However, most investigators have applied steady or pulsing flow profiles rather than oscillatory fluid flow, which occurs in vivo because of mechanical loading. Here oscillatory fluid flow was demonstrated to be a potentially important physical signal for loading-induced changes in bone cell metabolism. We selected three well known biological response variables including intracellular calcium (Ca(2+)i), mitogen-activated protein kinase (MAPK) activity, and osteopontin (OPN) mRNA levels to examine the response of MC3T3-E1 osteoblastic cells to oscillatory fluid flow with shear stresses ranging from 2 to -2 Newtons/m(2) at 1 Hz, which is in the range expected to occur during routine physical activities. Our results showed that within 1 min, oscillatory flow induced cell Ca(2+)i mobilization, whereas two MAPKs (ERK and p38) were activated over a 2-h time frame. However, there was no activation of JNK. Furthermore 2 h of oscillatory fluid flow increased steady-state OPN mRNA expression levels by approximately 4-fold, 24 h after exposure to fluid flow. The presence of both ERK and p38 inhibitors and thapsigargin completely abolished the effect of oscillatory flow on steady-state OPN mRNA levels. In addition, experiments using a variety of pharmacological agents suggest that oscillatory flow induces Ca(2+)i mobilization via the L-type voltage-operated calcium channel and the inositol 1,4,5-trisphosphate pathway.

Low-frequency physical activity insufficient for aerobic conditioning is associated with lower body fat than sedentary conditions

We aimed to show the relationships between reported physical activity, fitness level, and body composition in healthy adult office-working Kuwaiti males ( n = 45). Reported level of physical activity (group 0 = no routine exercise, n = 10; group 1 = routine exercise once per wk, n = 19; group 2 = routine exercise two or more times per wk, n = 16) was determined from recall questionnaires. Aerobic fitness levels were assessed from resting exercise heart rates and measurement of maximal oxygen uptake (treadmill exercise, Bruce protocol). Body composition was estimated from measurements of body weight, body height, and seven skin-folds. None of the subjects reported dieting to reduce or maintain their body weight. Despite minimal and not statistically significant differences in resting heart rates, VO 2max, VO 2max/kg body weight, and VO 2max/kg lean body mass, the sedentary group (group 0) had a much higher (12–14 kg) average body weight, higher (12–13 kg) body fat, and thicker skin folds than the more physically active groups 1 and 2. Groups 1 and 2 did not differ significantly from each other with regard to fitness and body composition parameters. Thus, routine physical activities insufficient to result in aerobic conditioning were found to be associated with lower body weight and lower body fat compared to those present in subjects reporting the total absence of any routine physical activity. These data are consistent with the hypothesis that even mild levels of routine physical activity are associated with levels of energy turnover that allow less intense and/or frequent periods of positive energy balance, resulting in maintenance of lower body fat than in totally sedentary people. Frequency of participation in routine physical activities may also reflect the level of non-exercise related physical activities and thus relate to the ability to minimize weight gain.

Substrate deformation levels associated with routine physical activity are less stimulatory to bone cells relative to loading-induced oscillatory fluid flow.

Although it is well accepted that bone tissue metabolism is regulated by external mechanical loads, it remains unclear to what load-induced physical signals bone cells respond. In this study, a novel computer-controlled stretch device and parallel plate flow chamber were employed to investigate cytosolic calcium (Ca2+i) mobilization in response to a range of dynamic substrate strain levels (0.1-10 percent, 1 Hz) and oscillating fluid flow (2 N/m2, 1 Hz). In addition, we quantified the effect of dynamic substrate strain and oscillating fluid flow on the expression of mRNA for the bone matrix protein osteopontin (OPN). Our data demonstrate that continuum strain levels observed for routine physical activities (< 0.5 percent) do not induce Ca2+i responses in osteoblastic cells in vitro. However, there was a significant increase in the number of responding cells at larger strain levels. Moreover, we found no change in osteopontin mRNA level in response to 0.5 percent strain at 1 Hz. In contrast, oscillating fluid flow predicted to occur in the lacunar-canalicular system due to routine physical activities (2 N/m2, 1 Hz) caused significant increases in both Ca2+i and OPN mRNA. These data suggest that, relative to fluid flow, substrate deformation may play less of a role in bone cell mechanotransduction associated with bone adaptation to routine loads.

Exercise physiology in patients with left ventricular assist devices.

LVAD use in the heart failure population is increasing and allows severely impaired patients an opportunity for exercise rehabilitation before cardiac transplantation. Although the LVAD provides nearly all of the cardiac output at rest, the native left ventricle contributes a modest amount during exercise, with the LVAD capable of providing a mechanical cardiac output of 10 L/min or greater. Given the parameters of the LVAD, exercise training responses should yield greater changes in submaximal exercise tolerance rather than changes in peak oxygen consumption. Heart rate and LVAD rate are driven by separate mechanisms but increase similarly during exercise. Blood pressure responses are somewhat variable early post LVAD implantation but normalize. Ratings of perceived exertion appear to be reliable and useful in this population. Evidence to date suggests that early mobilization and progressive exercise training in this population is safe and improves the transplantation experience. Although central contributions to oxygen consumption are limited by the inherent mechanical parameters of the LVAD, adequate cardiac output is provided for routine physical activities and moderate exercise training while the patient awaits transplantation.

Effect of total hip arthroplasty on cardiovascular fitness

Thirty patients who underwent total hip arthroplasty and 18 patients with medically treated arthritis participated in this study. Both groups of patients underwent a cardiovascular fitness exercise test on entering the study and 6 months, 1 year, and 2 years later. Fitness was assessed by patient performance on a graded maximal exercise test using a bicycle ergometer and metabolic cart. In the group of total hip arthroplasty patients, significant improvements in exercise duration ( P = .011), maximum workload ( P = .0013), peak oxygen consumption ( P = .0036), and percentage of predicted maximum oxygen uptake achieved ( P = .0002) were observed during the follow-up evaluation. In the group of control patients, decreases in exercise duration ( P = .0001), maximum workload ( P = .0001), and workload at anaerobic threshold ( P = .0108) occurred without a significant change in the other measures of cardiovascular fitness. The results indicate that resumption of routine physical activities after total hip arthroplasty is associated with a corresponding improvement in cardiovascular fitness.

Measurement of resting energy expenditure in patients with chronic obstructive pulmonary disease in a clinical setting.

There is a growing tendency to estimate energy requirements by means of the assessment of resting energy expenditure (REE) by indirect calorimetry. In this study a computerized open-circuit ventilated hood system is described that was constructed for assessing REE in a clinical setting. Measurement error of the device, tested by ethanol combustion was +2% for VO2 and VCO2 and less than 1% for respiratory quotient. To assess the within-patient variability of REE measurements performed in a daily clinical routine, we studied the following aspects of the measurements in several groups of patients with chronic obstructive pulmonary disease: (1) reproducibility, (2) the influence of routine physical activities before the measurement, (3) measurement duration, and (4) difference between measurements using a ventilated hood or a mouthpiece. Reproducibility of measurements with a 2-month interval in 12 weight-stable patients was good (1415 +/- 128 and 1398 +/- 138 kcal/day). Variations due to limited activities and different measurement durations (between 10 and 30 minutes) were not significant. Variations between measurements with a mouthpiece and ventilated hood were larger in patients than in healthy control subjects, but for both groups no systematic difference was established. REE can be assessed reliably by short-term measurements with a ventilated hood in stable chronic obstructive pulmonary disease patients on an outpatient basis, provided a short rest is taken before the measurement.

The Influence of Antecedent Exercise on Problem Behaviors in Persons with Mental Retardation: A Failure to Replicate

The purpose of this study was to evaluate the effects of a jogging program on behavior problems in adults with mental retardation. Six adults with severe mental retardation were exposed to sequential conditions of baseline (routine physical education activities), leisure games (attention control), and 15 minutes of daily jogging. The results showed that neither the jogging nor the leisure games condition produced consistent changes in problem behaviors. Possible explanations for this failure to replicate results of previous studies are discussed.

Functional status after coronary artery bypass grafting and percutaneous transluminal coronary angioplasty

Two cohorts of consecutive patients of comparable age with similar preprocedure cardiac function who underwent either coronary artery bypass grafting (CABG; n = 106) or percutaneous transluminal coronary angioplasty (PTCA; n = 64) were entered into a prospective comparison study examining functional status and return to work during the first year of recovery. Patients were evaluated using standardized functional status instruments for activities of daily living, work performance, social activity, mental health and quality of social interaction at 1, 6 and 12 months after the procedure. Within the CABG group, statistically significant improvements of functional status on every subscale were noted over the 1-year follow-up. Patients undergoing PTCA demonstrated significant improvement in all dimensions except for the quality of interaction at 1 year as compared with baseline. When the 2 groups were compared, the PTCA group demonstrated greater participation than the CABG group in routine daily physical and social activities at 1 and 6 months, but this apparent advantage disappeared by 1 year. Measures of psychological functioning were better after CABG than after PTCA. A reduction in the number of those with employment occurred in both the CABG and PTCA groups, independent of physical functional status measures, which improved in both groups after the procedures. For those with employment, the CABG group reported the greatest improvement in work performance.

Self-efficacy and in-patient cardiac rehabilitation

Self-efficacy reflects an individual's perceptions or beliefs about how capable he or she is of performing a specific activity or task and measures self-confidence to perform that specific activity or task. This study investigated the effect of in-patient cardiac rehabilitation on self-efficacy scores for 3 categories of activities: routine physical activities, daily living tasks and levels of concentration and ability to cope. On discharge from the intensive or coronary care unit, patients without contraindications to early ambulation were randomized to either a ward ambulation program (n = 26) or a dedicated exercise center program (n = 25) with all patients receiving the same standardized education/counseling. There were no differences between the groups in self-efficacy at baseline, at hospital discharge or 7 days later. Significant improvements in self-efficacy scores were observed by day 28 in both groups for routine physical activities and daily living tasks with no change in self-efficacy scores for concentration or ability to cope. At that time the exercise center patients had higher self-efficacy scores for walking time (p = 0.041) and overall exertion (p = 0.024) than the ward ambulation patients. For the majority of the self-efficacy variables considered, both in-patient exercise rehabilitation programs were equally effective in improving self-efficacy scores for physical activities and daily living tasks over the first 28 days after return to home. The lower cost associated with ward ambulation programs suggests that they are more cost-effective than developing a program in a dedicated in-patient exercise center.