Simple Exercise Research Articles

Inspiratory Muscle Strength Training to Improve Cardiometabolic Health in Patients with Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) is a complex, chronic metabolic disease that is associated with a high prevalence of comorbid conditions. Traditional lifestyle interventions (e.g., diet and exercise) can counter some adverse effects of T2DM; however, participation in these activities is low. High-resistance inspiratory muscle strength training (IMST) is a time-effcient and simple breathing exercise that significantly reduces blood pressure (BP) and improves vascular endothelial function in several nondiabetic populations. Herein, we performed a blinded, randomized, sham-controlled trial to investigate the effects of a 6-week IMST regimen (30 breaths/day, 6 days/week) on glycemic control and insulin sensitivity in adults with T2DM. Currently, we have eight participants (aged 35-71 years, 5 females and 3 males) who have completed either low-resistance sham training (15% maximal inspiratory mouth pressure, n=5) or high-resistance IMST (75% maximal inspiratory mouth pressure, n=3). Our data suggests that fasting plasma glucose and fasting serum insulin did not significantly change by IMST or sham training. Utilizing a homeostatic model assessment of insulin sensitivity to evaluate insulin action, our results indicate no change by either IMST or sham training. IMST revealed a trend towards a reduction in systolic BP (pre: 133.0 ± 4.8 vs. post: 128.8 ± 4.9) and diastolic BP (pre: 84.8 ± 2.7 vs. post: 81.7 ± 3.6). These findings align with prior research indicating improved resting BP, further corroborating previous studies. We performed an exploratory analysis to examine the potential impact of IMST on lipid levels. Interestingly, IMST resulted in a trend towards a reduction in cholesterol (pre: 259.3 ± 29.4 vs. post: 230.3 ± 3.7) and LDL (pre: 153.3 ± 19.7 vs. post: 127.7 ± 8.7). Analysis of the endothelial function data is forthcoming until we have enough individuals to complete those analyses. In conclusion, our results to date are preliminary; however, we expect to see continued improvements in resting BP and cholesterol/LDL with IMST. Moreover, with a higher number of individuals in the study (our goal is to have 12 in each group), we anticipate seeing changes in glycemia or insulin action. Lastly, IMST stands out as a distinctive and time-effective exercise method, addressing adherence challenges while demonstrating enhancements in cardiometabolic health. This could be particularly advantageous for T2DM patients with an increased cardiovascular disease risk. University of Arizona College of Medicine SPARK Grant. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

PUFFIn – A user friendly fast interface for calculating and visualizing the dose distribution in materials

This article describes a new graphical user interface that uses the PENELOPE Monte Carlo code to calculate dose distributions in materials. It is named PUFFIn, for the Penelope User-Friendly Fast Interface and was developed as an educational and scoping analysis tool for non-experts in radiation modeling. PUFFIn enables the user to visualize and compare the dose distributions in objects (e.g., sterilized healthcare products) irradiated with cobalt-60 gamma-rays, electron beam (E-beam) or X-rays. From such comparisons, the user can determine the most efficient product and/or packaging designs for any given radiation field – whether for conceptual or existing products and packaging.PUFFIn is distributed in a complete, self-contained package of software, including the PENELOPE radiation transport code, a standard graphics package, and a set of simple exercises. The package is available to any user at no cost and requires a minimal amount of training compared to other similar software. PUFFIn's capabilities are described, as well as validation measurements performed at Texas A&M University E-beam facility and the Aerial E-beam Facility in France.

Simulated impact of lift car sizes on transport of critical care patients: Informing the design of the New Dunedin Hospital.

The New Dunedin Hospital (NDH) is New Zealand's largest health infrastructure build. Here we describe the use of a simple simulation-based hospital design exercise to inform the appropriate lift car size for critical care intrahospital transfers in the NDH. The intensive care unit (ICU) user group tested a series of entries and exits of simulated complex patient transfers in mocked-up lift cars of three different dimensions. Time taken to enter and exit the lift were recorded, reflecting the relative difficulty of transfer. Qualitative assessments were made of ease and perceived safety of transfer. These simulations demonstrated that recommended standard patient lift cars, often proposed for critical care transfers, could not physically accommodate all complex ICU transfers. A size of 1800 mm wide (W) × 3000 mm deep (D) had the physical capacity to permit all simulated ICU transfers, but with staff and patient risk. As lift car size increased to 2200 mm W × 3300 mm D, the simulation demonstrated reduced transfer times, smoother entry and exit, improved access to the head end of the bed, and reduced risk of disconnection or dislodgement of lines and airway support. The resultant clinical recommendations for the dimensions of a critical care lift car surpass current international health architecture guidelines and may help to inform future updates. The NDH project benefited from an objective assessment of risk, in language familiar to clinicians and healthcare architects. The outcome was an upsizing of the two ICU-capable lifts.

Pressure and stiffness of a new air-inflated compression wrap.

To report pressure and stiffness, in healthy volunteers, of a new compression device with an air bladder inflated by a pump to regulate pressure. The device was applied to 60 legs of 30 volunteers and set to exert different pressures of 20-50mmHg. The exerted pressure was measured in supine and standing positions and during simple physical exercises; static stiffness index, dynamic stiffness index, and walking pressure amplitudes were calculated. The exerted pressure showed a good correlation with the expected pressure at each pressure range. The stiffness indices were >10mmHg in the range of inelastic materials. The device was considered very easy to apply and use by the testing researchers. The device stiffness is in the same range as the inelastic bandages. Consequently, similar hemodynamic effectiveness could be expected but must be proved. Unlike inelastic bandages, this device was easy to apply and use.

Effects of vitamin D3, omega-3s, and a simple strength training exercise program on bone health: the DO-HEALTH randomized controlled trial.

Evidence on the effects of Vitamin D, omega-3s, and exercise on areal bone mineral density (aBMD) in healthy older adults is limited. We examined whether vitamin D3, omega-3s, or a simple home-based exercise program (SHEP), alone or in combination, over 3 years, improve lumbar spine (LS), femoral neck (FN), or total hip (TH) aBMD assessed by DXA. Areal BMD was a secondary outcome in DO-HEALTH, a 3-year, multicenter, double-blind, randomized 2 × 2 × 2 factorial design trial in generally healthy older adults age ≥ 70years. The study interventions were vitamin D3 (2000IU/d), omega-3s (1g/d), and SHEP (3 × 30min/wk), applied alone or in combination in eight treatment arms. Mixed effects models were used, adjusting for age, sex, BMI, prior fall, study site, and baseline level of the outcome. Main effects were assessed in the absence of an interaction between the interventions. Subgroup analyses by age, sex, physical activity level, dietary calcium intake, serum 25(OH)D levels, and fracture history were conducted. DXA scans were available for 1493 participants (mean age 75years; 80.4% were physically active, 44% had 25(OH)D levels <20ng/mL). At the LS and FN sites, none of the treatments showed a benefit. At the TH, vitamin D versus no vitamin D treatment showed a significant benefit across 3years (difference in adjusted means [AM]: 0.0035 [95% CI, 0.0011, 0.0059] g/cm). Furthermore, there was a benefit for vitamin D versus no vitamin D treatment on LS aBMD in the male subgroup (interaction P = .003; ∆AM: 0.0070 [95% CI, 0.0007, 0.0132] g/cm). Omega-3s and SHEP had no benefit on aBMD in healthy, active, and largely vitamin D replete older adults. Our study suggests a small benefit of 2000IU vitamin D daily on TH aBMD overall and LS aBMD among men; however, effect sizes were very modest and the clinical impact of these findings is unclear.

Simple reflection exercises can build efficacy and reduce distress about relationship conflicts

AbstractSerious conflicts in close personal relationships can be highly distressing and tempting to ignore, but avoidance of conflict is maladaptive. In the present research, we tested the effectiveness of short conflict‐reflection interventions to promote constructive engagement with conflicts. In Study 1 (N = 358), a relatively unstructured, conflicted‐reflection intervention significantly reduced distress and bolstered confidence in partners' ability to resolve their relationship conflicts. Study 2 (N = 411) further revealed that this intervention was as, or nearly as effective as more elaborate interventions that prescribed specific, theory‐based, therapeutic elements. Together, results reveal that even brief episodes of constructive reflection on relationship conflicts can improve confidence and reduce distress about them. The positive effects of a relatively unstructured reflection suggest people already have adaptive intuitions about how to more effectively manage conflicts in their relationships and can benefit from brief reflections on how to apply them.

The consistent anti-cancer effect of a simple exercise (Ou MC decrescendo phenomenon exercise) may hold promise for low-cost cancer prevention.

The causal relationship between physical activity and anti-cancer effect are not proved by the current studies. However, Ou MC decrescendo phenomenon treatment (OuDPt), a simple exercise treatment, has shown consistent anti-cancer effects, which evinces the consequent anti-cancer effect by physical activity. The anti-cancer effects through OuDPt in the context of physical activity and human body anatomical axes showed to induce apoptosis, restore apical-basal polarity of cancer cells and mitigate epithelial-mesenchymal transition (EMT) with concomitant clinical regression of uterine endometrial cancer, suppression of ovarian and pancreatic cancer growth, regression of early suspicious pancreatic cancer, enhancement of chemotherapy effect of pancreatic cancer and cessation of cancer-related bleeding, which underlines the most important anti-cancer mechanisms. Although such anti-cancer effects by OuDPt show insufficient efficacy for advanced cancer in long-term treatment, OuDPt may be availed as an Ou MC decrescendo phenomenon exercise for cancer prevention. Further study is warranted.

The Effects of a Chatbot-Based Interpretation Bias Modification on Early Adulthood Depression

IntroductionDepression, particularly in early adulthood, presents a significant mental health challenge with far-reaching implications. Innovative approaches to address and alleviate depressive symptoms are of paramount importance in this context. One such approach involves the utilization of technology, specifically chatbot-based programs, to target specific cognitive biases associated with depression.ObjectivesThe central objective is to empirically examine whether this program can effectively influence depressive mood and negative cognition in individuals grappling with depressive symptoms.MethodsTo ascertain the program’s efficacy, participants were divided into two groups: the CBM-I group (n=20), which underwent interpretation bias modification training, and the Mood Check group(n=20), which served as a control and engaged in a simple mood-checking exercise. A battery of psychological measures was employed, including assessments of depression, interpretation bias, suicidal ideation, resilience, and attention control.ResultsAnalysis results showed that the CBM-I group had a significant reduction in depression (PHQ-9, CES-D) compared to the Mood Check group in the post-measurement. Moreover, resilience (CD-RISC) and attention control (ACQ) significantly improved in the CBM-I group.ConclusionsThis research serves as a stepping stone towards a deeper understanding of how chatbot-based interventions can contribute to the management of early adulthood depression, offering new perspectives and possibilities in the realm of mental health support and treatment.Disclosure of InterestNone Declared

Effectiveness of Foot Exercises together with the Hydrotherapy program on Blood Sugar Levels in Elderly People without Diabetes

Background: The elderly human population is susceptible to health problems due to decreased organ function. The risk of diabetes in old age also reduces quality of life. Preventing the risk of developing diabetes mellitus requires simple and simple exercise programs such as foot exercises and hydrotherapy. The effect of light leg exercise and hydrotherapy on carbohydrate metabolism is unknown. Objectives: To find out the impact of hydrotherapy alone or in combination with foot exercise on elderly's blood sugar levels. Methods: Parallel three-group pre and post-test designs for an experimental investigation. 21 elderly in RW 04 Karangwetan, Ungaran served as research participants, divided into control group (n=7), combination of foot exercises and hydrotherapy intervention group (n=7), and foot exercise intervention group (n=7). The intervention took place three times per week for five weeks. We used POCT to assess blood sugar levels. Results: There is no significant decrease in blood sugar levels from control group (p&gt;0.05). There is significant decrease in blood sugar levels from foot exercise and hydrotherapy intervention group (p&lt;0.05) and foot exercise intervention group (p&lt;0.05). The difference in blood sugar levels showed significant results between foot exercise and hydrotherapy intervention group and control group (p=0.000) and between foot exercise intervention group and control group (p=0.004). There is no significant differences in blood sugar levels between foot exercise and hydrotherapy intervention group and foot exercise intervention group (p=0.112). Conclusion: Simple exercise activities such as foot exercises together with hydrotherapy have been proven to reduce blood sugar levels in healthy elderly populations without diabetes

Modern technologies of physical recreation and mass sports in the context of the social project “Active parks – spaces of healthy Ukraine”

The main goal of the work is to highlight the organization of health-improving physical activity with the help of modern technologies for all categories of citizens, including persons with disabilities, internally displaced persons, war veterans, thanks to which conditions are created for reducing morbidity rates, improving the quality and duration of the active life of the population, and preventing diseases and overcoming their consequences in the conditions of martial law. During the implementation of events within the framework of the implementation of the social project, experts in the field of physical culture and sports, employees of physical culture and sports institutions, structural subdivisions for physical culture and sports of the regional and Kyiv city state administrations, specialists of public associations of physical culture and sports orientation or other entities in the field of physical culture and sports, which provide consultations and conduct practical classes. Leading athletes, trainers and other specialists in the field of physical culture and sports are involved in various types of physical activity and familiarization with sports.&#x0D; The social project "Active parks - locations of a healthy Ukraine" is being implemented directly by coordinators. This is a natural person, whose task is to organize and conduct events within the framework of the implementation of the social project, defined by the Regulation on the social project "Active parks - locations of healthy Ukraine" [1], for all categories of citizens, including persons with disabilities, internally displaced persons , war veterans, etc.&#x0D; The task of the research is to study the modern technology of physical recreation and mass sports of the social project "Active parks - locations of healthy Ukraine". The object of the research is the initiation of new forms of involvement of various population groups, including persons with disabilities, internally displaced persons and war veterans, in health-improving motor activity in places of mass recreation. The subject of the research is the creation of conditions for conducting events within the framework of the implementation of a social project on a permanent basis for different strata of the population with the help of modern technologies of physical recreation.&#x0D; Conclusions. It has been found that modern technologies of physical recreation and mass sports in the context of the social project "Active parks - locations of healthy Ukraine", in the framework of which even simple exercises are regularly performed with the help of a coordinator or online exercises strengthen the work of the immune system, increase the resistance of the human body to adverse factors of the external environment, which is one of the forms of physical recovery of all categories of citizens, including persons with disabilities, internally displaced persons and war veterans.

Ejercicios de Chi Kung como una propuesta de autocuidado en la experiencia migrante

The present reflection aims to propose the use of Chi Kung exercises as an alternative for self-care in the experience of migrants. This ancient technique, derived from traditional and complementary therapies, is presented as an accessible and easy-to-perform tool, allowing vulnerable populations to apply it. These are simple exercises that do not require a specific space or prolonged time each day. The sustained practice of these exercises promotes a sense of psychosocial comfort in individuals or their families.

The reverse stethoscope technique: a rapid intervention for old age hearing loss

ABSTRACT Objectives Presbycusis is highly prevalent, affecting between a third and two-thirds of elderly populations. Effective communication between patient and physician has been shown to directly correlate with the quality of patient care. The Reverse Stethoscope Technique (RST) involves placing the earpieces into the patient’s ears and speaking into the diaphragm. Here, we aim to show the RST is a simple and effective method to communicate with patients suffering from presbycusis in inpatient settings. Methods Medical inpatients aged >60 years old without cognitive impairment were included in the study. A simple repetition exercise of basic English sentences was performed with and without the RST to assess hearing ability. Patients then undertook a short questionnaire. Results Our study included 109 patients with varied ‘self-reported’ hearing. 50.5% of our cohort reported past communication difficulties with health-care professionals due to hearing difficulties. We identified that the RST increased the mean number of sentences a patient could repeat from 2.6 to 3.5 representing a statistically significant increase (p < 0.001). The technique was most beneficial for patients with ‘okay’ and ‘poor’ hearing. The majority of patients (77/109) also stated the technique reduced background noise. The RST was equally effective with facemasks. Conclusion Current techniques to enhance communication with patients with hearing loss are often underutilized or poorly accessible. Our study identified that the RST is a quick and effective solution that can be easily implemented for patients struggling to communicate with health-care professionals in inpatient scenarios.

Embodied cognitive restructuring: The impact of posture and movement on changing dysfunctional attitudes

Background and objectivesPrevious theoretical and empirical work has pointed to the important role of the body in emotion generation and emotion regulation. In the present study, we wanted to investigate if the performance of certain body postures and movement could facilitate cognitive restructuring of dysfunctional cognitive attitudes more effectively than traditional, verbal-only methods. MethodsIn total, 130 participants were randomized to one of two groups. One group was subjected to cognitive restructuring (i.e., restructure only group; CR-only), verbally exploring a dysfunctional attitude from a curious, strong, and courageous perspective. The other group received the same verbal instructions but in addition to this, was asked to perform different bodily exercises (i.e., motor-enhanced restructuring group; M-CR) supposed to enhance experience of the different perspectives from which cognitive restructuring was employed. ResultsResults confirmed the primary hypothesis, showing that the M-CR-group showed a larger decline in belief in dysfunctional attitudes compared with the CR-only group (F = 4.2, p = 0.041, d = 0.25). No differences on secondary outcomes were observed between the two groups. LimitationsFuture research should explore the effects of motor-enhanced CR both more long-term (e.g., durability over weeks) and in clinical samples (e.g., anxiety and depression). ConclusionShould the findings be replicated in clinical samples, it is encouraging that simple bodily exercises can enhance the effect of one of the most central skills of cognitive therapy.

Building program "wellness" for the correction of the figure of women of the first mature age

This article examines the importance of an approach to health and weight loss through the prism of the concept of Wellness in women. "Wellness" is a global approach to health care, covering physical, emotional and social well-being. The author emphasizes the importance of integrating "Wellness" into everyday life in order to achieve a sustainable and comprehensive approach to maintaining health and achieving weight loss goals.&#x0D; The article discusses the key components of wellness for women, including physical activity, nutrition, stress management, and psychological well-being. Practical tips and recommendations aimed at creating a healthy lifestyle adapted to the individual needs of women are provided.&#x0D; The article also emphasizes the importance of self-respect and a positive attitude towards one's body. "Wellness" calls for understanding the unique needs of each woman and creating a harmonious balance between physical and emotional well- being. The article provides practical advice on how to integrate simple exercise and healthy skills into women's busy daily lives.&#x0D; The following methods were used to achieve the goal: theoretical analysis and data processing, descriptive method, classification, systematization and generalization of scientific and methodical literature, sociological research methods and methods of mathematical statistics.&#x0D; The research was carried out at NUFVSU, at the Department of Health, Fitness and Recreation, as well as at the fitness studio "GLOW FLY&amp;DANCE" in Kyiv. Women in the first period of adulthood who work in the fitness studio "GLOW FLY&amp;DANCE" took part in the research. The total number of women is 40.&#x0D; Considering the effectiveness of a complex of wellness programs in correcting the figure of women in the first period of adulthood, a complex of high-interval training, cosmetology procedures, SPA procedures, as well as general nutritional recommendations was selected.&#x0D; Prospects for further research. Further research will be aimed at evaluating the effectiveness of the proposed program.

How can we encourage students to develop critical thinking skills?

The article discusses the role and importance of critical thinking as one of the important penetrating skills for the personal development of the student. There are also some examples of how to turn a simple exercise into a tool for developing critical thinking skills. With the mentioned activities, the student develops critical thinking, it is ensured that the teaching-learning process is focused on the student's personal development; The educational process is based on constructivist educational principles; A school culture focused on care and support is formed.

Step by Step: Evaluation of Cardiorespiratory Fitness in Healthy Children, Young Adults, and Patients with Congenital Heart Disease Using a Simple Standardized Stair Climbing Test.

(1) Background: Cardiorespiratory fitness (CRF) is known to be a prognostic factor regarding long-term morbidity and mortality. This study aimed to develop a standardized Stair Climbing Test (SCT) with a reliable correlation to spiroergometry and the 6MWT which can be used in healthy children as well as patients with congenital heart disease (CHD) and a restricted exercise capacity. (2) Methods: A total of 28 healthy participants aged 10-18 years were included. We tested the individuals' CRF by cardiopulmonary exercise testing (CPET) on a treadmill, the 6MWT, and a newly developed Stair Climbing Test (SCT). For the SCT, we defined a standardized SCT protocol with a total height of 13.14 m to achieve maximal exercise effects while recording time and vital parameters. To compare the SCT, the 6 Min Walking Test, and CPET, we introduced an SCT-Index that included patient data (weight, height) and time. To assess the SCT's feasibility for clinical practice, we also tested our protocol with five adolescents with complex congenital heart disease (i.e., Fontan circulation). (3) Results: A strong correlation was observed between SCT-Index and O2 pulse (r = 0.921; p < 0.001). In addition, when comparing the time achieved during SCT (tSCT) with VO2max (mL/min/kg) and VO2max (mL/min), strong correlations were found (r = -0.672; p < 0.001 and r = -0.764; p < 0.001). Finally, we determined a very strong correlation between SCT-Index and VO2max (mL/min) (r = 0.927; p = <0.001). When comparing the 6MWD to tSCT, there was a moderate correlation (r = -0.544; p = 0.003). It appears to be feasible in patients with Fontan circulation. (4) Conclusions: We were able to demonstrate that there is a significant correlation between our standardized SCT and treadmill CPET. Therefore, we can say that the SCT can be used as an easy supplement to CPET and in certain contexts, it can also be used as a screening tool when CPET is not available. The advantages would be that the SCT is a simple, quick, cost-effective, and reliable standardized (sub)maximal exercise test to evaluate CRF in healthy children on a routine basis. We can even assume that it can be used in patients with congenital heart disease.

Updating Turbomachinery Aerodynamics Teaching on an Undergraduate Course Using Three-Dimensional Design Tools

Abstract This paper outlines the update of a turbomachinery course to cover three-dimensional (3D) aerodynamics using a Reynolds-Averaged Navier Stokes solver. Prior to the activities outlined in this paper, the course was taught in a conventional way with a series of lectures and a timed, written, open book examination in a formal exam setting. Students were equipped with a calculator and set of notes including correlations from Howell and Soderberg. The students had around 1 h to answer the turbomachinery question, which was revealed to them only when they opened the paper at the start of the exam. This limited the depth of any aerodynamic problem they could get through and so they were restricted to simple design or analysis exercises. The genesis of the course update was the release in 2017 of “MULTALL OPEN” (Denton, J. D., 2017, “Multall: An Open Source, Computational Fluid Dynamics Based, Turbomachinery Design System,” ASME J. Turbomach., 139(12), p. 121001), a freely available turbomachinery design system, and this was adopted as the course software—although other software choices were considered. Students now produce two turbomachinery designs during the course. These are both based on the J85 turbojet—largely to keep cycle calculations to a minimum but it was also important to ensure that students recognize that they were completing a real engineering task. The first task was a 3D aerodynamic design of multistage turbine, which includes compressible flow, tip clearance, and stacking techniques such as lean or sweep. The second task was a midspan (two-dimensional) compressor design. The exact cycle conditions were varied each year to explore design scenarios such as an increase in firing temperature. Assessment was by means of a short report where the best students report on their design choices, provide critical analysis of the design using appropriate postprocessing techniques, and compare their designs to the state of the art in the wider literature. As well as describing the successes and challenges of the update to 3D design methods the paper provides some guidance for educators thinking about adopting a similar approach.

Korfball Coach Training in Klaten Regency, Central Java

The community service activity for training korfball coaches in Klaten Regency, Central Java aims to provide an understanding of training methods and an understanding of preparing training programs so that coaches can form and produce korfball athletes who excel in regional, national and even international championships. The method applied used a socialization approach with a training program followed by 50 participants consisting of teachers and football coaches in Central Java. The activity was held at KONI Klaten Regency for two days. The materials used in this activity are power points, teaching materials and videos as well as using laptops, projectors, mics and sound, stationery, documentation tools, korf and koftball balls. The first socialization material explains basic techniques, methods of training koftball and rules for playing koftball games. The second material discusses guidelines for preparing a simple exercise program. The third material discusses the importance of physiotherapy in the sport of korfball. Then the fourth material concerns physical training methods, techniques and tactics in korfball. The final material is about sports management in improving performance. After delivering all the material, it was continued with a korfball game simulation. The output of this activity is improving the quality of human resources for korfball coaches in Central Java.

1897 Older stroke survivors and rehabilitation therapists’ views on home-based resistance exercise for upper limbs

Abstract Introduction Upper limb recovery after stroke depends on participating in personalised task-specific exercise programmes. However, older adults with stroke find it challenging to maintain an optimal level of engagement with such exercise programmes due to personal and environmental factors. The aim of this study was to explore the views of stroke survivors and rehabilitation therapists on home-based resistance exercises for upper limbs. Method A qualitative study of semi-structured virtual and in-person interviews was conducted between January and March 2023 in England. Participants were 11 older adults &amp;gt;65 years (6 females (55%), with chronic stroke (&amp;gt;1 year after a stroke) and moderate to severe disabilities. Twenty rehabilitation therapists were also interviewed (3 physiotherapists, and 17 Action for Rehabilitation from Neurological Injury (ARNI) instructors). The group was asked about perceived personal and environmental barriers and facilitators as well as expectations of resistance exercises in relation to upper limb neurorehabilitation programmes. Interview sessions were audio recorded for transcription and thematic data analysis. The study was approved by Sheffield Hallam University ethics committee (reference number: AA43961583). Results Both groups mentioned that the main barrier to performing upper-limb exercises is weakness in the paretic arm affecting grip strength with consequent adverse impact on adherence to a home-based programme and poor patient motivation. Patients also reported safety concerns such as dropping equipment and being dependent on a carer to undertake regular exercises. Stroke survivors preferred a program that activates the paretic arm and is relevant to their daily functional activities. They preferred simple exercise instructions and demonstrations through visual aids and video materials. Patients also valued regular feedback on adjusting their exercise dose, monitoring progress over time, and ongoing encouragement. Conclusions Our study showed that designing home-based resistance exercises for upper limb in older stroke survivors should be individualised, functionally orientated, and motivational.

Prognostic significance of preoperative exercise tolerance in patients with early-stage lung cancer

ObjectiveTo investigate the influence of simple preoperative exercise tests as prognostic factors for early-stage lung cancer. MethodsThis single-institution retrospective study included consecutive patients who underwent pulmonary resection for stage 0 to I lung cancer between April 2017 and December 2019. Before surgery, 7 metabolic equivalents of task in the double Master 2-step test were loaded into the exercise echocardiogram. The relationship between prognosis and exercise stress test results in terms of availability, symptoms, and saturation of percutaneous oxygen was investigated. ResultsThis study included 862 patients with pathological stage 0 to I lung cancer. Among the 862 patients, 673 patients (78.1%) who were able to complete 7 metabolic equivalents of task exercise for 3 minutes without assistance were classified into the complete group. The 5-year survival of the complete group was significantly better than that of the incomplete group. Multivariable analysis revealed that age (hazard ratio, 1.06; P = .008), male sex (hazard ratio, 2.23; P = .011), carcinoembryonic antigen level >5 ng/mL (hazard ratio, 2.33; P = .011), and inability to complete 7 metabolic equivalents of task exercise (hazard ratio, 3.90; P < .001) were the prognostic factors. Patients in the older group who had the ability to complete exercise had a better prognosis than those in the younger group without the ability (P = .003). ConclusionsPreoperative exercise ability is a prognostic factor for early-stage lung cancer. Patients who can tolerate an exercise load of 7 metabolic equivalents of task, even if they are aged 70 years or older, have a better prognosis than patients younger than age 70 years without exercise tolerance.