Exercise Research Articles

Supervised vs home-based exercise program in kidney transplant recipients: A pilot pragmatic non-randomized study

BACKGROUND Although the benefits of exercise for kidney transplant recipients (KTRs) have been widely demonstrated, these patients experience several barriers in undertaking a structured exercise program in hospital and non-hospital facilities. AIM To compare the effects of a supervised moderate-intensity gym-based intervention with a home-based low-intensity walking program on exercise capacity in KTRs. METHODS KTRs were asked to choose between two six-month programs. The first group performed a low-intensity interval walking intervention at home-based exercise intervention (HBex). The second group performed a supervised training program at an adapted physical activity gym (Sgym), including aerobic and resistance training. The outcomes, collected at baseline and at the end of the programs, included the 6-minute walking test, the peak oxygen consumption (VO2peak) during a treadmill test, the 5-time sit-to-stand test, and blood pressure. RESULTS Seventeen patients agreed to participate and self-selected into the HBex (n = 9) and Sgym (n = 8) groups. Two patients in the Sgym group dropped out because of familial problems. At baseline, patients in the HBex group were significantly older and had lower walking distance, VO2peak, and lower limb strength. Primary outcome changes were significantly greater in the HBex group than in the Sgym group (52 ± 23 m vs 8 ± 34; P = 0.005). No other significant differences between groups were observed. Both groups improved most of the outcomes in the within-group comparisons, with significant variations in VO2 peak. CONCLUSION Six-month moderate-intensity supervised or low-intensity home-based training programs effectively improved exercise capacity in KTRs. Gym-based programs combine aerobic and resistance training; however, in-home walking may be proposed for frail KTRs.

Physical activity and wellbeing in prisoners: a scoping review.

This scoping review aims to evaluate the impact of physical activity interventions on the well-being of incarcerated individuals. It seeks to provide a comprehensive overview of existing research on various forms of physical activity, including structured exercise programs, yoga and mindfulness, and their effects on both mental and physical health within prison populations. A scoping review was conducted by searching Google Scholar, PubMed and Web of Science in June 2024. Keywords used included "physical activity," "exercise," "fitness," "sports," "prisoners," "inmates," "incarcerated individuals," "well-being," "mental health," "physical health," "psychological well-being" and "emotional well-being." After screening 1,736 potential articles, 54 relevant studies were selected. These included structured exercise programs, yoga/mindfulness programs and evaluations of physical activity levels. Two authors independently reviewed and selected studies based on predefined inclusion criteria, ensuring a comprehensive overview of the literature on physical activity interventions in prison settings. The review identified 12 relevant studies, revealing that physical activity interventions, including structured exercise programs, yoga and mindfulness, positively impact the psychological and physical well-being of incarcerated individuals. Consistent improvements were noted in mental health outcomes, such as reduced depression and anxiety, and enhanced physical health indicators, including lower body mass index and increased fitness levels. The findings underscore the necessity for age- and gender-specific interventions to address the unique health challenges faced by different inmate demographics, highlighting the importance of incorporating diverse and culturally relevant exercise programs in prisons. This review uniquely synthesizes the impact of various physical activity interventions on the well-being of incarcerated individuals, emphasizing the necessity for tailored, culturally relevant programs. Notably, no previous review has comprehensively analyzed this aspect. By comparing diverse types of interventions, it provides comprehensive insights into the benefits of structured exercise, yoga and mindfulness in prison settings. This work highlights the importance of implementing physical activity in various forms, especially for female inmates, to enhance health and well-being. It offers valuable guidance for developing effective rehabilitation strategies in correctional facilities.

Machine learning derived physical activity in preschool children with developmental coordination disorder.

To compare the device-measured physical activity behaviours of preschool children with typical motor development to those with probable developmental coordination disorder (pDCD) and at risk for developmental coordination disorder (DCDr). A total of 497 preschool children (4-5 years) in the Coordination and Activity Tracking in CHildren (CATCH) study completed repeated motor assessments and wore an ActiGraph GT3X on the right hip at baseline for 1 week. We calculated physical activity metrics from raw accelerometer data using a validated random forest classification machine learning model for preschool-age children. Analysis of variance (ANOVA) and linear regression models compared physical activity between typically developing children, children at risk for DCDr, and those with pDCD identified based on motor scores at baseline and averaged over time, accounting for age, sex, and accelerometer wear time. We found no differences in daily time spent sedentary, in light physical activity, or moderate-to-vigorous physical activity between typically developing children, children at risk for DCDr, and those with pDCD. However, children in the DCD groups spent less time doing ambulatory activities (walking/running) than typically developing children. Analysis of variance: baseline classification, DCDr to typically developing, run: F = 5.34, p = 0.005, classification averaged over time, DCDr to typically developing, walk: F = 5.82, p = 0.003. Regressions: DCDr compared to typically developing for walk: B = -3.47 (standard error 1.05), p < 0.001, pDCD compared to typically developing for run: B = -1.82 (standard error 0.62), p = 0.004. Designing interventions for preschool children with motor difficulties targeting specific physical activity types (walk/run) may help mitigate physical activity intensity differences observed later in childhood.

Effects of 10 Weeks of Walking With Mobile Step-Tracking Apps on Body Composition, Fitness, and Psychological State in Adolescents Who Are Overweight and Obese: Randomized Controlled Trial.

In recent decades, physical activity intervention programs have been developed to reduce overweight and obesity in adolescents. However, this population is considered hard to reach in physical activity programs due to lack of adherence and poor results. Interventions with mobile phones in the adolescent population with normal weight have shown benefits, so this line of research may provide benefits in adolescents with overweight or obesity, although it has not yet been explored in the scientific literature. This study aims to determine the changes produced by a 10-week intervention promoted during school lessons on physical education using step tracker mobile apps in out-of-school hours on physical activity, adherence to the Mediterranean diet, body composition, and the physical condition of adolescents who are overweight and obese, and to analyze the changes achieved by the 10-week intervention on the psychological state of adolescents who are overweight and obese. The study was based on a randomized controlled trial with an initial sample of 50 adolescents aged between 12 and 16 years (from the first to the fourth years of compulsory secondary education), whose body composition, physical activity level, physical condition, and psychological state were measured. Participants were divided into an experimental group (EG) and a control group (CG), where the EG performed a series of walking steps with a mobile app in their free time outside physical education classes. Adolescents in the CG continued to perform their physical activities as normal but did not use any mobile apps. Inclusion in the EG and CG was randomized, and the researchers were blinded. An increase was found in the EG in corrected arm girth (mean difference -0.46; P=.05), curl-up repetitions (mean difference -6.35; P=.02) and push-up repetitions (mean difference -2.27; P=.04) after the intervention. In the CG, there was a significant increase in hip girth (mean difference -1.37; P=.05), corrected thigh girth (mean difference -1.28; P=.04), and muscle mass (mean difference -0.87; P=.04), as well as a significant decrease in competence (mean difference 3.08; P=.03). The covariates gender and age showed an effect on corrected arm girth (gender: P=.04), curl-up repetitions (gender: P=.04) and push-up repetitions (gender: P=.04) in the EG; while in the CG it affected corrected thigh girth (gender: P=.04), adherence to the Mediterranean diet (gender: P=.04 and age: P=.047) competence (gender: P=.04 and age: P=.04) and relatedness (gender: P=.05 and age: P=.04). No significant differences were found when comparing changes in the CG and EG. A 10-week program of mobile app use by adolescents who are overweight and obese for physical activity outside of school hours does not appear effective in producing improvements in body composition, physical fitness, or adequate psychological state as it does not appear to significantly increase physical activity. ClinicalTrials.gov NCT06089876; http://clinicaltrials.gov/ct2/show/NCT06089876.

Associations of accelerometer-measured physical activity, sedentary behaviour, and sleep with next-day cognitive performance in older adults: a micro-longitudinal study

BackgroundPrevious studies suggest short-term cognitive benefits of physical activity occurring minutes to hours after exercise. Whether these benefits persist the following day and the role of sleep is unclear. We examined associations of accelerometer-assessed physical activity, sedentary behaviour, and sleep with next-day cognitive performance in older adults.MethodsBritish adults aged 50-83 years (N = 76) without evidence of cognitive impairment or dementia wore accelerometers for eight days, and took daily cognitive tests of attention, memory, psychomotor speed, executive function, and processing speed. Physical behaviour (time spent in moderate-to-vigorous physical activity [MVPA], light physical activity [LPA], and sedentary behaviour [SB]) and sleep characteristics (overnight sleep duration, time spent in rapid eye movement [REM] sleep and slow wave sleep [SWS]) were extracted from accelerometers, with sleep stages derived using a novel polysomnography-validated machine learning algorithm. We used linear mixed models to examine associations of physical activity and sleep with next-day cognitive performance, after accounting for habitual physical activity and sleep patterns during the study period and other temporal and contextual factors.ResultsAn additional 30 min of MVPA on the previous day was associated with episodic memory scores 0.15 standard deviations (SD; 95% confidence interval = 0.01 to 0.29; p = 0.03) higher and working memory scores 0.16 SD (0.03 to 0.28; p = 0.01) higher. Each 30-min increase in SB was associated with working memory scores 0.05 SD (0.00 to 0.09) lower (p = 0.03); adjustment for sleep characteristics on the previous night did not substantively change these results. Independent of MVPA on the previous day, sleep duration ≥ 6 h (compared with < 6 h) on the previous night was associated with episodic memory scores 0.60 SD (0.16 to 1.03) higher (p = 0.008) and psychomotor speed 0.34 SD (0.04 to 0.65) faster (p = 0.03). Each 30-min increase in REM sleep on the previous night was associated with 0.13 SD (0.00 to 0.25) higher attention scores (p = 0.04); a 30-min increase in SWS was associated with 0.17 SD (0.05 to 0.29) higher episodic memory scores (p = 0.008).ConclusionsMemory benefits of MVPA may persist for 24 h; longer sleep duration, particularly more time spent in SWS, could independently contribute to these benefits.

Особенности секреции интерлейкина-6 и скорость окисления жиров у детей с конституционально-экзогенным ожирением с различным уровнем физической активности

Physical inactivity is accompanied by a decrease of skeletal muscle mass and is one of the main reasons for obesity. Interleukin-6 (IL-6) acts as a paracrine and endocrine regulator of the intensity of carbohydrate and fat metabolism during exercises. The purpose of this research was to evaluate the fat oxidation rate and serum IL-6 in children with simple obesity depending on the level of daily physical activity (PA). Methods used: a cross-sectional, single-center sampling study that included 53 children aged 12 to 18 y/o (27 boys/26 girls) with obesity (SDS BMI 3.0 [2.6;3.3]) divided into two groups depending on the level of daily PA was conducted. The maximal fat oxidation (MFO) was assessed during ergometric stress testing with gas analysis. The IL-6 was assessed by ELISA at baseline and after a single physical activity. The level of daily PA was determined using the IPAQ international questionnaire Results: basal IL-6 level in children with obesity and low PA was 1.18 [0.42;1.55] pg/ml and was statistically significantly increased compared to the group of children without physical inactivity, 0.57 [0.22;0.8] pg/ml (p=0.029). The values of IL-6 after physical activity in both boys and girls with obesity and physical inactivity were statistically significantly increased compared with the group of children with obesity and moderate/high PA (p=0.032 and p=0.012 for boys and girls, respectively). The MFO in children with a low level of PA was 0.33 [0.22;0.41] g/min and did not significantly differ statistically from the group of peers with moderate or high PA (0.31 [0.25;0.36] g/min; p=0.431). Conclusion: a sedentary lifestyle in obese children leads to an increase in both basal and stimulated IL-6 secretion and is not accompanied by a decrease in maximal fat oxidation.

Supporting physical activity for health: What activities would people with transtibial amputation like to perform?

Participation in physical activity (PA) for health by people with transtibial amputation (PTTA) may moderate comorbidities experienced by this population. It is more likely that interventions which aim to increase participation by PTTA in PA for health will increase participation if the type of PA used is tailored to the preferences of the PTTA. This study aimed to identify the types of PA performed by PTTA, the types of PA PTTA who performed no physical activities would like to adopt, and if these outcomes were influenced by the cause of amputation. The cross-sectional survey was accessible through an online survey tool and in paper format. It was distributed primarily at sports events and relevant locations, which support people with limb differences. A total of 115 PTTA adults (both active and those who did not perform any physical activities) completed the survey, consisting of 65 people with amputation due to traumatic causes and 50 people with amputation due to nontraumatic causes. From all PTTA respondents, the most popular current activities were walking (N = 42), going to the gym (N = 39), swimming (N = 35), and cycling (N = 32). For PTTA who did not perform any physical activity, the most popular PA they would like to participate in were walking (N = 10), going to the gym (N = 8), swimming (N = 7), and cycling (N = 6). While there are differences in the hierarchy of popularity of different types of PA depending on the cause of amputation, these results indicate some consistencies. Walking, going to the gym, swimming, and cycling appear throughout the results, indicating a potential to encourage PTTA participation in PA for health through these activities.

Integrating accelerometry, GPS, GIS and molecular data to investigate mechanistic pathways of the urban environmental exposome and cognitive outcomes in older adults: a longitudinal study protocol

IntroductionMaintaining cognitive health in later life is a global priority. Encouraging individuals to make health behaviour changes, such as regular physical activity, and providing supportive urban environments can help maintain...

EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence.

There is growing interest in lifestyle interventions as stand-alone and add-on therapies in mental health care due to their potential benefits for both physical and mental health outcomes. We evaluated lifestyle interventions focusing on physical activity, diet, and sleep in adults with severe mental illness (SMI) and the evidence for their effectiveness. To this end, we conducted a meta-review and searched major electronic databases for articles published prior to 09/2022 and updated our search in 03/2024. We identified 89 relevant systematic reviews and assessed their quality using the SIGN checklist. Based on the findings of our meta-review and on clinical expertise of the authors, we formulated seven recommendations. In brief, evidence supports the application of lifestyle interventions that combine behavioural change techniques, dietary modification, and physical activity to reduce weight and improve cardiovascular health parameters in adults with SMI. Furthermore, physical activity should be used as an adjunct treatment to improve mental health in adults with SMI, including psychotic symptoms and cognition in adults with schizophrenia or depressive symptoms in adults with major depression. To ameliorate sleep quality, cognitive behavioural informed interventions can be considered. Additionally, we provide an overview of key gaps in the current literature. Future studies should integrate both mental and physical health outcomes to reflect the multi-faceted benefits of lifestyle interventions. Moreover, our meta-review highlighted a relative dearth of evidence relating to interventions in adults with bipolar disorder and to nutritional and sleep interventions. Future research could help establish lifestyle interventions as a core component of mental health care.

Association between youth blood pressure and exposure to pediatric fruit and vegetable prescriptions.

Health impacts of pediatric fruit and vegetable prescription programs (FVPPs) are unclear. This study assessed whether exposure to an FVPP that provided $15 produce prescriptions during pediatric visits was associated with differences in child diet, food security, physical activity, weight status, and blood pressure. This cross-sectional analysis included data from caregiver-child dyads with varying levels of exposure to the FVPP. Dyads completed surveys at pediatric offices. Trained research assistants measured height and weight of children and recorded blood pressure through chart review. Causal inference analyses using propensity score adjustments compared outcomes of exposure groups. 680 dyads enrolled. Youth who received ≥1 prescription (exposed) reported greater physical activity compared to youth who received no prescriptions (unexposed). Blood pressure percentiles were lower among exposed when compared to unexposed youth (63.273 versus 75.060 for SBP; 71.472 versus 77.548 for DBP); and fewer exposed children recorded elevated blood pressure when compared to unexposed (0.141 versus 0.343 for SBP; 0.199 versus 0.344 for DBP; and 0.286 versus 0.531 overall). Similar findings were obtained using duration as a measure of exposure. Youth exposed to the FVPP experienced greater physical activity and healthier blood pressure. Findings may indicate novel health-promoting effects of pediatric FVPPs. When compared to youth with no exposure, youth exposed to a pediatric fruit and vegetable prescription program recorded greater physical activity and healthier blood pressure. Youth with high exposure (≥24 months) to the fruit and vegetable prescription program experienced greater physical activity and healthier blood pressure when compared to youth with low exposure (<24 months). This extends evaluation of pediatric fruit and vegetable prescription programs beyond feasibility and preliminary effectiveness to indicate potential of such programs in positively influencing physical activity and blood pressure of participating youth. Findings indicate novel health-promoting effects of pediatric fruit and vegetable prescription programs.

Effect of physical activity on depression, anxiety, and stress in women surviving breast cancer: A systematic review and meta-analysis of randomized clinical trials.

Breast cancer treatment can lead to psychological distress, including depression, anxiety, and stress. We systematically investigated the effect of physical exercise on these factors in women surviving breast cancer (WSBC). Eight databases were searched to identify eligible randomized controlled trials (RCTs). Data extraction and bias risk analysis were conducted using standardized tools, with meta-analysis performed using RevMan® software. Out of 3529 documents initially identified, 15 RCTs were included, comprising 2756 WSBC (1284 in intervention groups and 1472 in control groups), with 2082 participants in depression analyses, 513 in anxiety analyses, and 161 in stress analyses. Meta-analyses showed that physical exercise promoted significant reduction in depression and anxiety. Subgroup analyses showed greater reduction in anxiety when aerobic and resistance exercise were combined. Only two studies investigated stress, with less robust data suggesting improvement when combining aerobic and resistance interventions. Future RCTs with standardized intervention protocols are needed to confirm these findings.

Biomechanics of physical exercise: A data-driven approach to enhancing mental health in college students

With growing awareness of the importance of mental health, the biomechanical mechanisms of physical exercise have gained attention as an effective intervention for improving mental well-being, particularly among college students. Physical activity not only enhances physical fitness and disease resistance but also contributes to cognitive and emotional health through specific biomechanical pathways. This study explores the interplay between exercise biomechanics and mental health by investigating the psychological challenges faced by college students. Utilizing advanced data analysis and correlation techniques, we refine the Apriori algorithm through a novel database partitioning strategy, achieving a 23.68% improvement in accuracy and a 10.17% reduction in runtime compared to the baseline. Additionally, this study examines how biomechanical factors, such as joint movement and muscle activity, influence brain function and mental health outcomes. The findings offer innovative perspectives for integrating biomechanical insights into mental health education and exercise-based interventions for college students.

Gamified Mobile Health Strategies for Promoting Physical Activity in Autistic Adults.

Physical inactivity and sedentarism among autistic adults are a growing public health concern. Focusing on the integration of behavior change theories and emphasizing the unique preference for visuospatial learning and gaming technology, we hypothesize that gamified mobile health (mHealth) applications can be effective at increasing free-living physical activity and reducing sedentary behavior in autistic adults.

Physeal-Sparing Anterior Cruciate Ligament Reconstruction For Skeletally Immature Knee: A Case Report

Introduction : ACL injuries are common in the knee and often caused by non-contact sports or dynamic valgus knee movements. There has been an increase in competitive sports at younger ages, resulting in higher levels of competition and greater recognition of sports injuries by coaches and specialists. Case Report : Patient is a 14 year old woman with the initials RNF came to the emergency room of the hospital with complaints of pain in the right knee accompanied by a feeling of instability after suffering an injury while playing football with the mechanism of injury: when the patient was running and was about to change direction by supporting her right leg, suddenly the patient felt pain and there was a sound in the right knee area. After history, physical examination, and supporting test, diagnosis was made as complete ACL tear and surgery was planned in the form of ACL reconstruction using the physeal sparing technique. Discussion : The risk of ACL damage is greater in young and active individuals. The physeal-sparing technique is a relatively safe approach with few complications. It reduces knee pain at the donor site and lowers the risk of nerve damage. This method also reduces the risk of joint damage after physical activity. Young athletes who returned to sports after ACL reconstruction showed a much higher rate of injury, with a 30 to 40 times greater risk of ACL injury compared to uninjured youth. Effective communication among patient and specialist therapeutic is crucial for a successful surgery and safe return to sports and daily activities. Conclusion : Full ACL reconstruction using a physeal-sparing technique in young patients is a safe method that protects the growth plate and avoids the complications. However, further research is needed to determine the long-term effectiveness of this approach in treating ACL injuries in young patients.

Exploring patients’ views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries: a qualitative interview study

ObjectivesThis study aimed to generate new qualitative insights to understand the rehabilitation needs of people living with a confirmed or presumed diagnosis of ischaemia with no obstructive coronary arteries (INOCA),...

Взаимосвязь миокинов и саркопенического ожирения с неалкогольной жировой болезнью печени при конституционально-экзогенном ожирении у детей

Obesity in children is associated with high risk for development and progression of nonalcoholic fatty liver disease (NAFLD). NAFLD has common pathogenetic mechanisms with sarcopenic obesity (SO), in the development of which such myokines as fibroblast growth factor 21 (FGF-21) and irisin play an important role. The study of their secretion peculiarities is relevant to the prospects of using myokines as diagnostic markers or indicators for drug therapy and physical activity control as well as in the development of target therapy for NAFLD. The connection between NAFLD and SO and changes in myokine profile in children is an understudied issue. The purpose of this research was to determine differences between groups of pediatric patients with the presence v. those with the absence of NAFLD in constitutional-exogenous obesity in myokine and SO levels. Methods used: a single-stage comparative single-center uncontrolled study of 95 children aged 12 to 18 y/o with constitutional-exogenous obesity: body mass index (BMI) standard deviation score (SDS)≥+2.0. Results: NAFLD was detected in 48% (n=50/95) [95% CI (42; 63)] of whom steatohepatitis was detected in 40% (n=20/50) [95% CI (26; 55)]. SO was detected in 96% (n=48/50) [95% CI (86; 99)] with NAFLD including children with steatohepatitis (n=20). The combination of SO with elevated FRF-21 levels and decreased irisin was associated with NAFLD (AUC=0.761, [95% CI (0.65; 0.87)]). The SO frequency was statistically significantly higher in NAFLD than in the SO absence (p&lt;0.001). The predictive ability of the SO presence in relation to the detection of NAFLD was found to be high (PCPR=96%, [95% CI (88; 99)]). FRF-21 values above 60 pg/mL (AUC=0.689, [95% CI (0.57; 0.81)]) and irisin values below 7.86 μg/mL (AUC=0.703, 95% CI (0.58; 0.82)]) were associated with the presence of NAFLD. When comparing operational characteristics, no differences were found for AUC value while the best performance was demonstrated by regression model and cut-off point of irisin equal to 7.86 μg/mL. Conclusion: SO combined with changes in myokine profile is associated with NAFLD. Identification of the main factors influencing the NAFLD development in childhood is crucial in preventing the progression of liver damage.

Modifiable Risk Factors for Subarachnoid Hemorrhage: Narrative Review With an Emphasis on Common Controversies and Epidemiologic Pitfalls.

Given the relatively low incidence, high prehospital death rate, substantial geographical differences, and complex disease origin (combination of genetic and environmental risk factors), epidemiologic research on subarachnoid hemorrhage (SAH) and its risk factors is challenging. In practice, we are more or less forced to exploit compromised study designs and nonrepresentative data in such circumstances where it is almost impossible to gather comprehensive data through an optimal design. For example, hospital-based patient cohorts, administrative data repositories, and short-term population-based studies from small geographical regions are often used to research the incidence, case fatality, and risk factors of SAH, regardless of their inherent and self-evident limitations. Since studies on the epidemiology of SAH focus largely on identifying possible risk factors that could aid in disease diagnostics, treatment, and prevention, we aimed to review recent evidence on modifiable risk factors for SAH. In this context, we also try to explain the methodological reasons behind some of the conflicting results and to discuss the primary strengths and limitations of different study designs used in the field of SAH epidemiology. Based on our findings, smoking, high blood pressure, and possibly low physical activity are the only risk factors with high-quality evidence supporting their causal role in SAH. In addition, since all 3 commonly used study designs in SAH epidemiology, namely, hospital-based, population-based, and administrative register-based studies, have their own strengths and limitations, the most robust risk factor estimates and other epidemiologic measures of SAH can likely be established by combining various overlapping and high-quality sources of information in the future.

The Impact of Structured Physical Activity on Glycemic Control and Metabolic Outcomes in Patients with Type 2 Diabetes: A Randomized Controlled Trial

Background: Type-2 diabetes is a major health challenge, requiring effective interventions for glycemic and metabolic control. Structured physical activity offers a promising non-pharmacological approach to improving these outcomes. Objectives: The objective of this study was to evaluate the effects of structured physical activity on glycemic control and metabolic outcomes in patients with Type-2 diabetes (T2D). Methods: This randomized controlled trial included 200 adult patients with T2D, randomly assigned to one of three groups: structured exercise once a week, thrice a week or usual care. Participants followed for 6 months and exercise interventions were combined aerobic and resistance training. Hemoglobin A1c (HbA1c) and fasting glucose the primary while Body mass index (BMI), waist circumference and lipid profiles were secondary outcomes Results: HbA1c was reduced significantly more in the thrice-weekly exercise group (-0.38%, p = 0.005) than in the once week group (-0.16%, p &gt; 0.05) or control group. Changes in the once weekly group were not significant, whereas the thrice weekly group’s fasting glucose levels improved significantly (-0.25%, p &lt; 0.05). BMI and lipid profile improvements were also more pronounced in the thrice weekly group with greater reductions in total cholesterol and LDL cholesterol compared to other groups. Conclusion: Thrice-weekly structured exercise significantly improves glycemic control and metabolic outcomes in T2D compared to once-weekly regimens, highlighting the importance of exercise frequency. Future research should focus on strategies to enhance adherence to frequent exercise programs.

Personal physical activity and physical activity counselling among primary healthcare providers in Nigeria primary healthcare centres

ABSTRACT Physical activity is an essential public health goal with crucial evidence in the prevention of non-communicable diseases thus examined in this study. The objective of the study was to determine the prevalence of personal physical activity and its association with physical activity counselling among primary healthcare providers in Osun state, South-west Nigeria. It was a descriptive cross-sectional study that used a pre-tested self-administered questionnaire. Two hundred and eighty primary healthcare providers in Osun state, Nigeria, were recruited using a multi-stage sampling technique. The chi-square test was used to determine the association between personal physical activity and physical activity counselling. Among the respondents, the prevalence of personal physical activity was 78.2% while 70.0% usually counselled their patients on physical activity. Barriers to physical activity counselling include poor knowledge of physical activity recommendations, lack of time and counselling protocols. There was a significant association between personal physical activity and physical activity counselling (χ2 = 8.930, p = 0.003). This study concluded that there was a high prevalence of personal physical activity and an association between personal physical activity and physical activity counselling among the respondents. The findings suggest a need for continued education programmes for primary healthcare providers to improve their knowledge of current physical activity recommendations, and sufficient time should be allowed during consultations for the physical activity counselling process.

Pulmonary and Physical Virtual Reality Exercises for Patients With Blunt Chest Trauma: Randomized Clinical Trial.

Adequate pain relief, early restoration of breathing, and rapid mobilization pose a clinical challenge in patients with blunt chest trauma. Virtual reality (VR) has the potential to achieve these 3 interrelated treatment objectives with enhanced self-efficacy and autonomy of patients and limited support by clinicians. This study aimed to assess the effectivity of breathing and physical exercises using VR on the pulmonary recovery of patients with blunt chest trauma at the ward. A pilot randomized controlled trial was performed. The control group received usual physiotherapy consisting of protocolized breathing exercises (8 times daily for 10 minutes) and physical exercises (2 times daily for 10 minutes). The VR group was instructed to perform these exercises using VR. The primary outcome was vital lung capacity at day 5 or earlier at discharge. Secondary outcomes were patient mobility (time standing, lying, and sitting), clinical outcomes (length of hospital stay, pulmonary complications, transfer to intensive care unit, and readmission within 30 days), pain, activities of daily living, patient-reported outcome measures (satisfaction and quality of recovery). Patient experiences and barriers and facilitators toward implementation were assessed through interviews. The study was prematurely ended due to enrollment failure combined with poor protocol adherence to exercises in both groups. A total of 27 patients were included, of which 19 patients completed 3 or more days. Vital lung capacity at 5 days (or last measurement) was equal between groups with 1830 (SD 591) mL and 1857 (SD 435) mL in the control and VR groups, respectively. No marked differences were observed in secondary outcomes. Patient interviews showed positive attitudes toward the use of VR, describing that visualization of the exercises helped patients to perform the exercises correctly and to continue the exercises for a longer duration. Also, patients experienced the immersiveness of VR as an analgesic. However, patients did not experience added value over usual care and reported that better integration in treatment and the hectic hospital environment could improve the use of the VR exercises. The suitability of patients to use virtual reality therapy (VRx) in a hospital (trauma) ward setting is lower than generally expected. Effective application of VRx requires professional guidance and needs thorough alignment with clinical practice. For future research, we recommend to chart adherence to study protocol before designing a VR clinical trial. Patient-reported experiences need to be prioritized in evaluating VR acceptance, usability, and effectiveness. In line, we recommend performing a systematic analysis (eg, using the technology acceptance model) on the acceptance before pilot or main effectiveness studies. Finally, the eligibility of patients and exclusion of patients due to the inability to use VRx should be routinely reported. ClinicalTrials.gov NCT05194176; https://tinyurl.com/2bzh4tzx.