Effect of Buerger’s Exercises on Improving Peripheral Circulation: A Systematic Review

The aim of this study was to systematically review the evidence for the effectiveness of Buerger’s exercise on the peripheral circulation or diabetic foot ulceration. A systematic search and 18 electronic databases were conducted. The intervention was predominantly focused on Buerger’s exercise as an outcome. Due to high heterogeneity, data were synthesized in a narrative format rather than by statistical methods. Nine studies that covered 592 participants were selected in the analysis, of which 8 of the 9 found an effect of Buerger’s exercise on peripheral circulation. The positive effects were indicative of improving blood flow, walking ability, reducing necrosis, reducing venous embolism, pain, swelling, cyanosis and the bed-rest times. However, the study design and quality appraisal were limited to Jadad score 2 and the sample size was small. Findings provide some evidence of the beneficial effects of Buerger’s exercises. It was seen as a low cost and low risk physical activity that most diabetic patients could undertake at home. This review highlighted a need for further investigation of standardized procedures of Buerger’s exercises. More high quality studies on the prevention of diabetic foot are required regarding Buerger’s exercises.

Additive neurorestorative effects of exercise and docosahexaenoic acid intake in a mouse model of Parkinson’s disease

There is a need to develop interventions to slow or reverse the degeneration of dopamine neurons in Parkinson’s disease after diagnosis.Given that preclinical and clinical studies suggest benefits of dietary n-3 polyunsaturated fatty acids,such as docosahexaenoic acid,and exercise in Parkinson’s disease,we investigated whether both could synergistically interact to induce recovery of the dopaminergic pathway.First,mice received a unilateral stereotactic injection of 6-hydroxydopamine into the striatum to establish an animal model of nigrostriatal denervation.Four weeks after lesion,animals were fed a docosahexaenoic acid-enriched or a control diet for the next 8 weeks.During this period,the animals had access to a running wheel,which they could use or not.Docosahexaenoic acid treatment,voluntary exercise,or the combination of both had no effect on(i)distance traveled in the open field test,(ii)the percentage of contraversive rotations in the apomorphine-induction test or(iii)the number of tyrosine-hydroxylase-positive cells in the substantia nigra pars compacta.However,the docosahexaenoic acid diet increased the number of tyrosine-hydroxylase-positive terminals and induced a rise in dopamine concentrations in the lesioned striatum.Compared to docosahexaenoic acid treatment or exercise alone,the combination of docosahexaenoic acid and exercise(i)improved forelimb balance in the stepping test,(ii)decreased the striatal DOPAC/dopamine ratio and(iii)led to increased dopamine transporter levels in the lesioned striatum.The present results suggest that the combination of exercise and docosahexaenoic acid may act synergistically in the striatum of mice with a unilateral lesion of the dopaminergic system and provide support for clinical trials combining nutrition and physical exercise in the treatment of Parkinson’s disease.

Exercise and exerkine upregulation:Brain-derived neurotrophic factor as a potential non-pharmacological therapeutic strategy for Parkinson’s disease

Physical activity and exercise have several beneficial roles in enhancing both physiological and psychological well-being of an individual.In addition to aiding the regulation of aerobic and anaerobic metabolism,exercise can stimulate the synthesis of exerkine hormones in the circulatory system.Among several exerkines that have been investigated for their therapeutic potential,Brain-derived neurotrophic factor(BDNF)is considered the most promising candidate,especially in the management of neurodegenerative diseases.Owing to the ability of physical activity to enhance BDNF synthesis,several experimental studies conducted so far have validated this hypothesis and produced satisfactory results at the pre-clinical level.This review highlights some of the recent animal model studies that have evaluated the efficiency of exercise in enhancing BDNF synthesis and promoting neuroprotective effects.Further,this review focuses on understanding the therapeutic benefits of exercise-induced exerkine synthesis as a non-pharmacological strategy in Parkinson’s disease(PD).Regarding physical activity and exerkine induction,the neuromuscular electrical stimulation(NMES)strategy could be considered as an alternate treatment modality for patients affected with PD.

Analysis of current status of and barriers to exercise participation among patients on maintenance hemodialysis

Objective:The objective of this study was to analyze the current status of barriers to exercise participation(EP)among patients on maintenance hemodialysis(MHD).Materials and Methods:A cross-sectional study was conducted on 277 outpatients undergoing MHD in 2 tertiary first-class hospitals in Beijing from February 2023 to June 2023 who were selected using convenience sampling method.The data of patients on MHD were collected using the general information questionnaire,Physical Activity Rating Scale,Exercise Benefits/Barriers Scale(EBBS),and Exercise Self-Efficacy Scale(ESES).The relationship between EP and barriers to EP was analyzed through univariate and multivariate linear regression models.Results:Patients on MHD had a low exercise volume score of 13.71±0.68 points and a medium EBBS score of 63.36±0.40 points.Multivariate logistic analysis showed that exercise volume was significantly related to the following four aspects,including low monthly household income per capita(odds ratio[OR]=86.741,95%confidence interval[CI][1.164-6.465],P=0.042),primary underlying disease of diabetic nephropathy(OR=45.993,95%CI[1.353-1.564],P=0.033),the belief that“fatigue in lower extremities hinders exercise”(OR=4.697,95%CI[1.127-19.585],P=0.034),and the belief that“physical exercise bringing optimistic and positive life attitude”(OR=0.074,95%CI[0.007-0.830],P=0.035).Conclusions:Since patients on MHD had low physical exercise volume,the health-care provider should pay more attention on the controllable factors that affect the EP of patients on MHD.Therefore,feasible and effective intervention measures can be formulated based on ESES in clinical nursing.

Student’s Health Exercise Recognition Tool for E-Learning Education

Due to the recently increased requirements of e-learning systems,multiple educational institutes such as kindergarten have transformed their learning towards virtual education.Automated student health exercise is a difficult task but an important one due to the physical education needs especially in young learners.The proposed system focuses on the necessary implementation of student health exercise recognition(SHER)using a modified Quaternion-basedfilter for inertial data refining and data fusion as the pre-processing steps.Further,cleansed data has been segmented using an overlapping windowing approach followed by patterns identification in the form of static and kinematic signal patterns.Furthermore,these patterns have been utilized to extract cues for both patterned signals,which are further optimized using Fisher’s linear discriminant analysis(FLDA)technique.Finally,the physical exercise activities have been categorized using extended Kalmanfilter(EKF)-based neural networks.This system can be implemented in multiple educational establishments including intelligent training systems,virtual mentors,smart simulations,and interactive learning management methods.

Effects of Physical Exercise and Music Therapy on Cognitive Aspects in Tunisian Patients with Mild Alzheimer’s Type Dementia

Aim: The objective of this research is to highlight the effectiveness of physical exercise and music therapy in older patients with Alzheimer’s disease (AD). Methods: Patients with a mild level of AD were included in this study, divided into the therapy group (TG;N = 30, aged 68 ± 3.2 years) and the control group (CG;N=30, aged 65 ± 2.6 years). The therapy group was enrolled in an exercise-training program (walking, resistance and balance exercises) combined with musical therapy for 10 weeks (three sessions of 60 minutes per week). The Control group was instructed to follow their daily rhythm of life (e.g., rest, reading) under the same conditions. The intervention program was enrolled under the supervision of;one psychologist;a neurologist;two music therapists, and two physiotherapists, all belonging to the same hospital unit. After 10 weeks of participation in the combined program, cognitive parameters were improved in the therapy group measured with the Behavior Pathology in Alzheimer Disease (BEHAVE-AD), (p < 0.05) for activity disturbance, diurnal rhythm disturbances, anxieties and phobias, affective disturbance. The percentage range of improvements is 1.07% to 2.96%. Results: Our results demonstrate that physical exercise combined with music therapy improves cognitive function in patients with Alzheimer’s disease. Conclusions: Physical exercise and music therapy are beneficial combined treatments for improving life quality in older patients. This approach may be useful to help patients with a mild level of Alzheimer’s disease improve their behavioral and psychological parameters.

The Impact and Intervention of Handheld Tai Chi Water-Resistance Fitness Ball on Middle-Aged and Elderly Patients with Parkinson’s Disease

Through the use of a survey and statistical methods, this study explores the effects and interventions of handheld Tai Chi water resistance fitness balls on the elderly with Parkinson’s disease. Firstly, a questionnaire on exercise compliance for patients with Parkinson’s disease was developed, and its reliability and validity were tested. Then, a survey was conducted to investigate the current status of exercise compliance among Parkinson’s disease patients, including general information, scoring status, and single and multiple factor analyses of influencing factors [1]. The results of the study show that through qualitative research, the dimensions and item pools of the questionnaire were initially constructed, and the reliability analysis of the questionnaire was conducted through Delphi expert consultation, with favorable results in terms of its reliability and validity [2]. Regarding the current status of exercise compliance among Parkinson’s disease patients, the study found that the level of exercise compliance needs improvement, and there are significant differences in exercise compliance levels among patients under different circumstances. Finally, the research results were discussed and conclusions were drawn. The innovation of this study lies in the development of a questionnaire on exercise compliance for patients with Parkinson’s disease and the preliminary qualitative research and Delphi expert consultation conducted on it, providing new ideas and methods for the study of exercise compliance. However, the study also has limitations as it did not examine the effects of other interventions on Parkinson’s disease, so further research should be conducted [3].

超声引导下连续腰交感神经节阻滞治疗下肢Buerger′s病的顽固性疼痛

目的观察超声引导下腰交感神经节阻滞治疗下肢Burger′s病的顽固性疼痛的疗效。方法 40例Buerger′s病患者随机均分为两组。超声引导下治疗组(A组):采用便携式彩色二维超声仪引导下行患侧连续腰交感神经节阻滞,置管两周;对照组(B组)给予抗抑郁药、抗惊厥药物治疗,观察期为两周。监测记录两组患者治疗前和治疗2周后的疼痛VAS评分、患肢皮温和有无血管神经及脏器损伤、恶心呕吐、感觉异常、运动减退、视物模糊、共济失调等不良反应的发生率。结果与B组比较,A组治疗2周后疼痛明显缓解,VAS评分显著下降,皮肤温度明显升高(P<0.01),且无其他严重并发症发生。结论超声直视引导下连续腰交感神经节阻滞技术,可提高穿刺成功率,减少并发症,可在下肢Buerger′s病所致神经病理性疼痛治疗中发挥短期效应。

TRIF在Buerger’s病患者腰交感神经节中的表达及其意义

目的观察β干扰素Toll样受体结构域衔接蛋白(Toll/IL-1 receptor domain containing adaptor inducing IFN-β,TRIF)在Buerger’s病患者腰交感神经节中的表达,探讨TRIF在Buerger’s病发病中的作用机制。方法收集2012年8月至2013年5月我院行腰交感神经节切除术的Buerger’s病患者手术标本30例为Buerger’s病组,同期肝移植供体者腰交感神经节6例为对照组。应用免疫组化、反转录PCR(RT-PCR)技术及蛋白质印迹(Western blot)技术测定2组腰交感神经节中TRIF的表达水平并且比较组间差异。进一步采用激光共聚焦技术,检测TRIF在Buerger’s病患者神经元中的表达特点。结果 Buerger’s病患者腰交感神经节中TRIF的mRNA和蛋白表达水平明显高于对照组(P<0.01)。并且,在Buerger’s病患者腰交感神经节组织中,TRIF主要分布于神经细胞之中。结论 TRIF与Buerger’s病的发生和发展关系密切;Toll样受体信号通路激活可能是Buerger’s病发病的重要因素。

转录因子激活蛋白-1在Buerger’s病中的表达与意义

目的:观察转录因子激活蛋白-1(activator protein-1,AP-1)在Buerger’s病患者腰交感神经元内的表达。方法:收集2011年1月至2012年3月行腰交感神经节切除术的Buerger’s病男性患者腰交感神经节标本,Buerger’s病患者组:23例,对照组:12例。应用免疫组化、RT-PCR、Western blot技术测定对照组腰交感神经节神经元AP-1的表达水平并比较其表达差异。结果:Buerger’s病患者腰交感神经节神经元中AP-1的基因表达(P=0.045 9)、蛋白表达(P=0.028 3),高于对照组。结论:AP-1在调节Buerger’s病细胞增殖和血管炎症反应中发挥着作用。

腰2交感神经节阻滞治疗双下肢Buerger's病顽固性疼痛的临床疗效研究

目的观察腰2交感神经节阻滞治疗双下肢血栓闭塞性脉管炎(下肢Buerger's病)神经病理性疼痛的疗效。方法在C型臂机X线引导下行双侧腰2交感神经节阻滞。结果治疗组与对照组相比,疼痛明显缓解,视觉模拟评分(VAS)显着下降,皮肤温度明显升高,且无其他并发症发生。结论腰2交感神经节阻滞对双下肢血栓闭塞性脉管炎(下肢Buerger's病)神经病理性疼痛有较好的治疗效果。

转录因子激活蛋白-2在Buerger’s病中的表达与意义

目的:观察转录因子激活蛋白-2(transcription factor activator protein-2,AP-2)在Buerger’s病中的表达与分布。方法:临床收集2011年1月至2012年3月共23例行腰交感神经节切除术Buerger’s病患者腰交感神经节标本,应用RT-PCR、Western blot方法检测AP-2在Buerger’s病组中基因和蛋白的表达变化,使用免疫组化的方法检测AP-2在Buerger’s病组中的表达分布规律,以观察在该组中的表达特点。临床收集12例正常病例标本以同样方法处理。结果:RT-PCR和Western blot结果显示,与正常对照组中相比,Buerger’s病组中AP-2基因和蛋白表达水平具有统计学差异(P<0.05),免疫组化显示病理组AP-2表达高于正常组,主要分布在细胞核。结论:Buerger’s病组中AP-2水平升高,表明AP-2在Buerger’s病的发生与发展过程中可能发挥了重要作用。

MyD88在Buerger’s病血管组织中的表达及其意义

目的对Buerger’s病患者血管中的髓样分化因子(myeloid differentiation factor88,My D88)进行检测,观察My D88在Buerger’s病患者血管中的表达及分布。方法收集2013年7月至2015年7月我院Buerger’s病患者血管标本9例,同期非Buerger’s病(肿瘤、外伤)患者血管标本12例为对照组。运用RT-PCR、Western blot技术检测2组血管中My D88的表达水平。同时运用免疫组化、免疫荧光技术检测Buerger’s病血管中My D88的表达及分布规律。结果 RT-PCR、Western blot结果显示,与对照组相比,Buerger’s病患者血管组织中My D88的m RNA和蛋白表达水平明显升高,具有显著统计学意义(P<0.01)。免疫组化、免疫荧光结果显示,在Buerger’s病患者血管组织中,My D88主要表达于内皮细胞和平滑肌细胞。结论 Buerger’s病患者血管组织中My D88基因和蛋白表达水平明显升高,且主要表达于血管平滑肌细胞和内皮细胞。这些结果表明My D88可能与Buerger’s病的发病密切相关,TLRs-My D88信号通路在Buerger’s病的发病机制中可能发挥着重要作用。

Role of exercise in preventing and restoring gut dysbiosis in patients with inflammatory bowel diseases:A review

Inflammatory bowel diseases(IBD)include a spectrum of chronic inflammatory disorders of the gastrointestinal tract whose pathogenesis is yet to be elucidated.The intestinal microbiome has been studied as a causal component,with certain microbiotic alterations having been observed in subtypes of IBD.Physical exercise is a modulator of the intestinal microbiome,causing shifts in its composition that are partially corrective of those observed in IBD;furthermore,physical exercise may be beneficial in patients with certain IBD subtypes.This review studies the effects of physical exercise on the human gut microbiome while investigating pathophysiologic mechanisms that could explain physical activity’s clinical effects on patients with IBD.

下肢Buerger’s病患者腰交感神经节神经元中DBH的改变

目的研究下肢Buerger’s病患者腰交感神经节神经元中去甲肾上腺素合成酶——多巴胺-β-羟化酶(dopaminebetahydroxylase,DBH)的表达。方法采用免疫组织化学SP法检测14例Buerger’s病患者和11例非Buerger’s病患者腰交感神经节神经元中DBH的表达水平。结果Buerger’s病患者神经元内DBH表达有高于正常人的总体趋势,差异具有统计学意义(P<0.05)。结论DBH的表达增强可使血管更多的处于痉挛状态,促进了本病的发生发展。

Aquaporin 4 deficiency eliminates the beneficial effects of voluntary exercise in a mouse model of Alzheimer’s disease

Regular exercise has been shown to reduce the risk of Alzheimer’s disease(AD).Our previous study showed that the protein aquaporin 4(AQP4),which is specifically expressed on the paravascular processes of astrocytes,is necessary for glymphatic clearance of extracellular amyloid beta(Aβ)from the brain,which can delay the progression of Alzheimer’s disease.However,it is not known whether AQP4-regulated glymphatic clearance of extracellular Aβis involved in beneficial effects of exercise in AD patients.Our results showed that after 2 months of voluntary wheel exercise,APP/PS1 mice that were 3 months old at the start of the intervention exhibited a decrease in Aβburden,glial activation,perivascular AQP4 mislocalization,impaired glymphatic transport,synapse protein loss,and learning and memory defects compared with mice not subjected to the exercise intervention.In contrast,APP/PS1 mice that were 7 months old at the start of the intervention exhibited impaired AQP4 polarity and reduced glymphatic clearance of extracellular Aβ,and the above-mentioned impairments were not alleviated after the 2-month exercise intervention.Compared with age-matched APP/PS1 mice,AQP4 knockout APP/PS1 mice had more serious defects in glymphatic function,Aβplaque deposition,and cognitive impairment,which could not be alleviated after the exercise intervention.These findings suggest that AQP4-dependent glymphatic transport is the neurobiological basis for the beneficial effects of voluntary exercises that protect against the onset of AD.

The Effects of Exercise on People with Parkinson’s Disease—Review

Quality of life encompasses physical, psychological and social aspects of health. Apart from motor symptoms (physical aspects), Parkinson’s disease (PD) is also closely related with various non-motor symptoms (psychological and social aspects) that can undermine quality of life greatly, even in early stages of the disease. Most research studies in this field focus on analysis of motor symptoms in PD sufferers. Although benefits of physical activity for the psychosocial quality of life are well-known, they have been mostly neglected in case of the people suffering from PD. Numerous studies clearly show that training programs can ameliorate the quality of life as far as non-motor functions in PD sufferers are concerned. The only psychological aspects of the disease related to the effects of exercise that have been researched so far are depression and cognitive functions. Depression is the most common denominator of poor quality of life, while dementia often accompanies the Parkinson’s disease. Studies have shown positive effects of exercise on the social life of those suffering from the disease, especially in case of group exercise. Studying psychological and social aspects of such chronic conditions as PD is of utmost importance for monitoring the patient’s adjustment to the disease, functioning with it, as well as the overall well-being and satisfaction with life. Thus far, the results have been pointing towards improvement of the quality of life. Exercise is a readily available method of treatment in case of PD, especially if applied in the early stages of the disease. In addition to reviewing the existing studies on the relation between exercise and quality of life of the patients, this paper will also focus on the way the psychological and social aspects of PD are influenced by exercise.

Inter-individual differences in the responses to aerobic exercise in Alzheimer’s disease: Findings from the FIT-AD trial

Background:Despite the strong evidence of aerobic exercise as a disease-modifying treatment for Alzheimer’s disease(AD)in animal models,its effects on cognition are inconsistent in human studies.A major contributor to these findings is inter-individual differences in the responses to aerobic exercise,which was well documented in the general population but not in those with AD.The purpose of this study was to examine inter-individual differences in aerobic fitness and cognitive responses to a 6-month aerobic exercise intervention in community-dwelling older adults with mild-to-moderate dementia due to AD.Methods:This study was a secondary analysis of the Effects of Aerobic Exercise for Treating Alzheimer’s Disease(FIT-AD)trial data.Aerobic fitness was measured by the shuttle walk test(SWT),the 6-min walk test(6MWT),and the maximal oxygen consumption(VO2max)test,and cognition by the AD Assessment Scale-Cognition(ADAS-Cog).Inter-individual differences were calculated as the differences in the standard deviation of 6-month change(SDR)in the SWT,6MWT,VO2max,and ADAS-Cog between the intervention and control groups.Results:Seventy-eight participants were included in this study(77.4±6.3 years old,mean±SD;15.7±2.8 years of education;41%were female).VO2max was available for 26 participants(77.7±7.1 years old;14.8±2.6 years of education;35%were female).The SDR was 37.0,121.1,1.7,and 2.3 for SWT,6MWT,VO2max,and ADAS-Cog,respectively.Conclusion:There are true inter-individual differences in aerobic fitness and cognitive responses to aerobic exercise in older adults with mild-tomoderate dementia due to AD.These inter-individual differences likely underline the inconsistent cognitive benefits in human studies.

Repeated application of autologous bone marrow-derived stem cell therapy in patients with severe Buerger’s disease

Stem cell therapy (SCT) is a promising and prospective approach in the treatment of patients with severe peripheral arterial disorders, primarily with Buerger’s disease. However, very little is known about the duration of the effect of SCT, and to our best knowledge no data are available on the efficacy and safety of repeated SCT in patients with Buerger’s disease. Here we report on two patients with severe Buerger’s disease, who received repeated autologous bone marrow-derived stem cell therapy. Our results show that a second SCT, applied to a previously treated leg 30 or 36 months after the first treatment was efficient in both cases. After twelve months, the clinical state of the repeatedly treated lower limb improved spectacularly and non-healing ulcers healed more rapidly than after the first SCT. No severe adverse events were detected. Thus repeated SCT offers a safe and efficient treatment option for relapsing patients at the advanced stage of Buerger’s disease.