Effect of Individualized Exercise Therapy on Cancer-related Fatigue and Negative Emotion in Patients with Gastrointestinal Tumor during Perioperative Period

[Objectives]To investigate the effect of exercise therapy in gastric cancer patients during perioperative period.[Methods]100 patients with gastric cancer who underwent elective operation in the Department of Gastrointestinal Surgery of Taihe Hospital Affiliated to Hubei University of Medicine were divided into observation group and control group by convenience sampling.The control group received routine nursing measures,and the experimental group received exercise therapy intervention measures on the basis of the control group.The patients were evaluated by the General Information Questionnaire,Self-Rating Anxiety Scale,Self-Rating Depression Scale and Cancer-related Fatigue Scale at the time of admission,the second week and the sixth week after operation.[Results]The time effect,intervention effect and interaction effect of anxiety score,depression score and cancer-related fatigue score were significant(all P<0.05)and the index of enhanced recovery after surgery was significant(P<0.05)in the two groups at the second and sixth week after operation.[Conclusions]Exercise therapy is beneficial to promoting the enhanced recovery after surgery in advance,reduce cancer-related fatigue,negative emotion and accelerate rehabilitation in patients with gastrointestinal tumors.

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.

Exercise-induced modulation of miR-149-5p and MMP9 in LPS-triggered diabetic myoblast ER stress: licorice glycoside E as a potential therapeutic target

Background:This study explores the relationship between endoplasmic reticulum(ER)stress and diabetes,particularly focusing on the impact of physical exercise on ER stress mechanisms and identifying potential therapeutic drugs and targets for diabetes-related sepsis.The research also incorporates traditional physical therapy perspectives,emphasizing the genomic insights gained from exercise therapy in disease management and prevention.Methods:Gene analysis was conducted on the GSE168796 and GSE94717 datasets to identify ER stress-related genes.Gene interactions and immune cell correlations were mapped using GeneCard and STRING databases.A screening of 2,456 compounds from the TCMSP database was performed to identify potential therapeutic agents,with a focus on their docking potential.Techniques such as luciferase reporter gene assay and RNA interference were used to examine the interactions between microRNA-149-5p and MMP9.Results:The study identified 2,006 differentially expressed genes and 616 miRNAs.Key genes like MMP9,TNF-α,and IL1B were linked to an immunosuppressive state.Licorice glycoside E demonstrated high affinity for MMP9,suggesting its potential effectiveness in treating diabetes.The constructed miRNA network highlighted the regulatory roles of MMP9,IL1B,IFNG,and TNF-α.Experimental evidence confirmed the binding of microRNA-149-5p to MMP9,impacting apoptosis in diabetic cells.Conclusion:The findings highlight the regulatory role of microRNA-149-5p in managing MMP9,a crucial gene in diabetes pathophysiology.Licorice glycoside E emerges as a promising treatment option for diabetes,especially targeting MMP9 affected by ER stress.The study also underscores the significance of physical exercise in modulating ER stress pathways in diabetes management,bridging traditional physical therapy and modern scientific understanding.Our study has limitations.It focuses on the microRNA-149-5p-MMP9 network in sepsis,using cell-based methods without animal or clinical trials.Despite strong in vitro findings,in vivo studies are needed to confirm licorice glycoside E’s therapeutic potential and understand the microRNA-149-5p-MMP9 dynamics in real conditions.

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.

Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrhea-predominant irritable bowel syndrome patients

BACKGROUND Irritable bowel syndrome(IBS)is a common digestive system disease with a high incidence rate and is common in women.The cause of IBS remains unclear.Some studies have shown that mental and psychological diseases are independent risk factors for IBS.At present,the treatment of IBS is mainly symptomatic treatment.Clinically,doctors also use cognitive behavioral therapy to improve patients'cognitive ability to diseases and clinical symptoms.In recent years,exercise therapy has attracted more and more attention from scholars.Improving the symptoms of IBS patients through psychosomatic treatment strategy may be a good treatment method.AIM To explore the effects of an intervention of cognitive behavioral therapy combined with exercise(CBT+E)on the cognitive bias and coping styles of patients with diarrhea-predominant irritable bowel syndrome(IBS-D);and to provide a theoretical reference for the management of IBS.METHODS Sixty IBS-D patients and thirty healthy subjects were selected.The 60 IBS-D patients were randomly divided into experimental and control groups.The experimental group was treated with the CBT+E intervention,while the control group was treated with conventional drugs without any additional intervention.The cognitive bias and coping styles of the participants were evaluated at baseline and after 6 wk,12 wk and 24 wk using the Automatic Thoughts Questionnaire(ATQ),Dysfunctional Attitudes Scale(DAS)and Pain Coping Style Questionnaire(CSQ)instruments,and the intervention effect was analyzed using SPSS 17.0 statistical software.RESULTS At baseline,the scores on the various scales showed that all subjects had cognitive bias and adverse coping styles.The IBS Symptom Severity Scale(IBSSSS)scores,ATQ total scores,DAS scores and CSQ scores of the two groups were not significantly different(P>0.05).Compared with baseline,after 6 wk of the CBT+E intervention,there were significant differences in the ATQ scores,the dependence and total scores on the DAS,and the catastrophization,distraction and prayer scores on the CSQ(P<0.05).After 12 wk,there were significant differences in the scores for perfectionism on the DAS and in the scores for reinterpretation,neglect and pain behavior on the CSQ in the experimental group(P<0.05).After 24 wk,there were significant differences in the vulnerability,dependence,perfectionism,and total scores on the DAS and in the catastrophization,distraction and prayer scores on the CSQ in the experimental group(P<0.01).The IBS-SSS scores were negatively correlated with the ATQ and DAS total scores(P<0.05)but were positively correlated with the CSQ total score(P<0.05).CONCLUSION Intervention consisting of CBT+E can correct the cognitive bias of IBS-D patients and eliminate their adverse coping conditions.CBT+E should be promoted for IBS and psychosomatic diseases.

Effects of Exercise on Cancer-related Fatigue and Quality of Life in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: A Meta-analysis of Randomized Clinical Trials

Objective To gain insight on how exercise affects the outcomes of prostate cancer patients treated with androgen deprivation therapy,specifically cancer-related fatigue(CRF) and quality of life(QoL). Methods Systematic searches for randomized clinical trials(RCTs) evaluating the effects of exercise on CRF and QoL of prostate cancer patients receiving androgen deprivation therapy were carried out to identify the eligible studies from EMBASE,Pub Med and Cochrane library. Related data were extracted from eligible studies and then subjected to Reviewer Manage 5.3 for analysis. Standardized mean differences(SMD) and its 95% confidence interval(CI) were calculated. Results In all,10 RCTs involving 841 prostate cancer patients(448 of whom exercised and 393 did not) were included in this study. With respect to CRF,there was good consistency among different studies,and it was remarkably reduced in the exercise group(SMD=-0.32,95% CI:-0.45 to-0.18,P<0.00001,n=784). In regards to QoL,there was also good consistency among different studies,and it was also improved significantly in the exercise group(SMD=0.21,95% CI:0.08 to 0.34,P=0.002,n=841). Conclusion Exercise both reduced CRF and improved QoL in prostate cancer patients receiving androgen deprivation therapy.

Cardiac rehabilitation and exercise therapy in the elderly： Should we invest in the aged？

冠的心疾病(CHD ) 是世界范围的死亡的领先的原因并且在病人之中变得逐渐地流行 65 岁以上。老病人在为复杂并发症的更高的风险并且在一个心血管的事件以后加速物理 deconditioning，特别与他们的更年轻的对应物相比。最后几十年是到与 CHD 在病人之中在死亡，锻练能力，心理风险因素，发炎，和肥胖上表明了心脏的康复(CR ) 和锻练治疗的有益的效果的多重研究的厕所。不幸地，这个领域里的可得到的数据的重要部分与更年轻的病人相关。可行解释是更老的病人在为以病人开始并且延长到医生的多重原因的这些节目是非常未被充分代表的。在这篇文章，我们将考察 CR 节目的好处在之中老，以及一些妨碍他们的参予的障碍。

Management of Rhabdomyolysis and Acute Renal Failure Following Strenuous Exercise in Young Adult: A Case Report

Introduction: Rhabdomyolysis is severe and life threating condition in which skeletal muscles are damaged by dissolution of striped muscles. Acute kidney injury (AKI) has been widely reported (13% - 50%) as a complication of Rhabdomyolysis in which the main pathophysiological mechanisms are intra-renal vasoconstriction, intraluminal cast formation (Tamm-Horsefall) and direct myoglobin toxicity. In this report we are going to describe the management of Acute Kidney Injury due to Rhabdomyolysis that is not responding to vigorous rehydration. Objective: Reporting about acute renal failure induced by Rhabdomyolysis due to Excessive Exercise and dehydration in young patient. Case Report: A 20 years male came to the outpatient clinic complaining of sever lower limb pain, back pain and vomiting. He was anuric and hypertensive (BP = 150/90 mmHg) with serum creatinine and urea levels of 15.72 mg/dl and 235 mg/dl, respectively. The diagnosis was based on the laboratory finding of creatine kinase = 3127 IU/l. The patient, then, has been referred to the emergency department. The Management plan was based on two arms: Emergency Management with Urgent Hemodialysis for AKI and high fluid replacement therapy. Patient started to recover after three hemodialysis sessions but the peak of recovery was noted after starting manual fluid replacement therapy with a target urine output of greater than 2 ml/kg, a urine pH of greater than 6. Manual fluid replacement therapy consisted of loop diuretics, intravenous fluids and intravenous sodium bicarbonate 1.26%. Full recovery was noted after one month of hospital admission with inpatient care and regular follow-up. A follow-up after one month has been set to assess the patient progression and monitor his kidney functions. Relevance and Impact: Home messages and lessons are;Firstly, young adults are vulnerable to Rhabdomyolysis, second, the diagnosis of Rhabdomyolysis can be made on the clinical bases but a confirmatory laboratory test of Creatine Kinase is mandatory, and lastly’ acute kidney injury needs to be treated urgently. Also, reducing the risk of infection is one of the management objectives to achieve recovery.

Integration of Chinese herbal medicines and exercise for insomnia:a systematic review and meta-analysis

Background:As a disease,insomnia is often ignored by the general public.Insomnia,which not directly fatal,may be equivalent to chronic suicide if it is not paid attention to.However,there are many theories on how to treat insomnia,and researchers have been searching for a cure.Chinese herbal medicine(CHM)and exercise therapy(ET)are relatively effective,and have been used since ancient times to treat insomnia.This study aimed to examine the effect of CHM combined with ET(CHM-ET)on patients with insomnia.Methods:We searched eight electronic databases including PubMed,Web of Science,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure(CNKI),the China Biology Medicine disc(CBMdisc),the China Science and Technology Journal Database(VIP),the Wanfang Database to find randomized controlled trials(RCTs)evaluating CHM-ET in the treatment of insomnia patients up to September 13,2022.Two researchers read and screened the publications to extract data.We used the pittsburgh sleep quality index(PSQI)as the evaluation indicators for each study,and the other was the total effective rate(TER).The Cochrane risk-of-bias assessment tool was used to assess the risk of bias of the included literature.The level of evidence for this result was assessed by GARDE method.The meta-analysis was performed using STATA 14 software and RevMan 5.3.The research method was registered with PROSPERO(CRD42022350926).Results:We included fourteen randomized controlled trials,which including a total of 1,126 participants.Compared with the control group,the experimental group showed significantly improvements in sleep effect as reflected by the reduced PSQI score[mean difference(MD)=-2.47,95%confidence interval(CI)(-3.15,-1.78),I^(2)=92%]with low quality of evidence,and increased TER[risk ratio(RR)=1.23,95%CI(1.14,1.33),I^(2)=40%]with moderate quality of evidence.Compared with hypnotic drugs,CHM-ET significantly reduced the PSQI score[mean difference(MD)=-3.18,95%CI(-5.48,-0.89),I^(2)=73%]with low quality of evidence.The PSQI of CHM-ET significantly decreased compared with single CHM[mean difference(MD)=-3.04,95%CI(-5.84,-0.25),I^(2)=98%]with low quality of evidence,and ET[mean difference(MD)=-2.44,95%CI(-2.87,-2.02),I^(2)=0%]with moderate quality of evidence.No serious adverse reactions were observed.Conclusion:This review suggested that CHM-ET may be an effective treatment for insomnia.However,given the limited quality of the studies and methodologies included in the trials,further rigorous randomized controlled trials are needed for more accurate results.

Effective of exercise therapy on functional balance, physical performance and quality of life among patients undergoing hemodialysis: randomized controlled trial

Background:Patients undergoing hemodialysis suffer from deteriorating physical health,impaired physical function,and have a low quality of life,that explained by insufficient metabolic clearance.To overcome these obstacles,cost-effective strategies must be developed,including exercise as a complement to hemodialysis therapy.Objective:To determine the effectiveness of exercise therapy on functional balance,physical performance,and quality of life among patients undergoing hemodialysis:a randomized controlled trial.Methods:This randomized controlled trial study was carried out on 68 patients with chronic kidney disease undergoing hemodialysis for at least six months and had a medically stable condition who were randomly divided into training(n=32)exercise therapy and(n=31)control,groups.The training group participated in 8-week(3 sessions per week)resistance exercise therapy in three sets of 10 repetitions of knee extension,hip flexion,and hip abduction with the use of an elastic band under the supervision of a training physiotherapist and researcher during the first hour of the three routine hemodialysis treatment session per week.But the control group did not experience any intervention.To analyze the data,two-way analysis of variance and Bonferroni statistical tests were used at the significant level of(P=0.05).Results:6 Minute-Walk Test(6MWT)(0.013),and in the Physical Activity Scale for the Elderly(PASE)(0.014),and Short Survey Form 36(SF-36)questionnaires and health-related quality of life(HRQOL)(0.001)had significant improvements in the training group in comparison to the control group from pre to post-test,also physical performance(0.001)was improving as compared with control group(0.89)at(P=0.05).Conclusion:Resistance exercise therapy interventions for eight weeks effectively improve the physical function and performance,activity levels,and health-related quality of life of patients with chronic kidney disease and undergoing regular hemodialysis compared with a control group.

Age and Gender-Related Differences in Physical Functions of the Elderly Following One-Year Regular Exercise Therapy

Reports on physical functions during maintenance period of the elderly with cardiac and other serious diseases are limited. This study aims to clarify age and gender-related differences in their physical functions. Participants included 167 elderly individuals (males, 78;mean age, 76.5 years;SD = 6.0 years;females, 89;mean age, 75.5 years;SD = 4.5 years) who participated in a 1-year regular exercise therapy twice a week. The following eight physical function tests were selected: grip strength, 10-m obstacle walking time, one-legged balance with eyes open, sit-ups, sitting trunk flexion, 6-min walk, stepping by sitting position, and a timed up & go (TUG). Two-way analysis of variance was used to examine mean differences by gender and age: young elderly group (aged 65 - 74 years) and old elderly group (aged ≥ 75 years). In the grip strength, sit-ups, 6-min walk, 10-m obstacle walking time, stepping by sitting position, and sitting trunk flexion tests, males were superior in the former four tests, and females were superior in the latter two tests. The young elderly group was superior in all tests except for sit-ups compared with the old elderly group. The balance during one-legged with eyes open test was superior in males compared with females in the young elderly group, but decreased in males in the old elderly group. In conclusion, physical functions of the elderly during maintenance period are different between genders. Muscle strength, muscle endurance, whole-body endurance, and walking ability are superior in males, whereas flexibility and agility are superior in females. The old elderly group was inferior in all the elements of physical function except muscle endurance.

Exercise Training Post Cardiac Resynchronization Therapy Improves Exercise Tolerance and Quality of Life

Background: Cardiac resynchronization therapy (CRT) results in improved morbidity, mortality, symptoms, quality of life (QOL) and exercise capacity, in appropriate chronic heart failure (CHF) patients. Moreover, combined exercise training (ET) and CRT maximize these improvements in these patients. The study evaluated the effect of ET on these patients in terms of QOL, functional class, exercise capacity and left ventricular ejection fraction (LVEF). Results: There were significant improvements in the QOL, functional class, exercise capacity, and LVEF compared with the Control Group. Comparison of both groups confirmed the cumulative effects of ET with CRT. The QOL improved by the end of training in the exercise group (p = 0.001), compared to the Control Group (p = 0.850). NYHA functional class improved significantly in the Exercise Group (p = 0.013). Percent-predicted peak oxygen consumption (VO2 peak) had significantly improved in the trained (p < 0.001) versus the untrained CRT Group (p= 0.596). There was a mean percent rise of the ejection fraction from 39.2 ± 12.86 to 44.40% ± 14.42% in the Exercise Group compared to a non-significant change in the Control Group. Conclusion: ET in resynchronized CHF patients is feasible and further enhances QOL and exercise tolerance in addition to the improvements seen after CRT. The study therefore recommends for the prescription of ET after implantation in order to maximize the expected benefit.

Tubular conduits,cell-based therapy and exercise to improve peripheral nerve regeneration

Peripheral nerve injuries （PNI） are a major clinical prob- lem. In general, PNI results from motor vehicle accidents, lacerations with sharp objects, penetrating trauma （gunshot wounds） and stretching or crushing trauma and fractures. It is estimated that PNI occur in 2.8% of trauma patients and this number reaches 5% if plexus and root lesions are in- cluded. However, due to lack of recent epidemiological stud- ies, these data probably underestimate the actual number of nerve injuries

Application effect of exercise rehabilitation therapy in elderly patients with chronic heart failure

Objective:To investigate the effects of rehabilitation exercise therapy on 6-minute walking distance (6 minute walk distance, 6MWD), brain natriuretic titanium (Brain natriuretic peptide, BNP) and (Minnesota heart failure quality of life scale, MLHFQ score in elderly patients with chronic heart failure (CHF).Methods: Choose xi'an medical college affiliated hospital heart treated with 96 cases of elderly patients with chronic heart failure (from January 2016 to January 2018), according to random number table method, divide the patients as control group and observation group 48 cases/group, control group to implement regular heart failure treatment, the observation group in the control group, the implementation of rehabilitation exercise therapy on the basis of comparing the clinical curative effect of two groups of indicators, heart colour to exceed, 6 MWDS, BNP levels, plate movement, MLHFQ score. Results: (1) compared with the control group, the total effective rate of the observation group was higher than that of the control group (P<0.05). (2). After treatment, the left ventricular end-diastolic diameter (Left ventricular end diastolic diameter, LVEDD) and the left ventricular end-systolic diameter (Left ventricular end systolic diameter, LVESD), BNP) in the observation group were higher than those in the control group. All the MLHFQ scores were lower than those in the control group (P<0.05). The left ventricular ejection fraction (Left ventricular ejection fraction, LVEF), stroke output (Stroke volume, SV) and treadmill metabolic equivalent (Metabolic equivalent, METs) were higher than those in the control group (P<0.05). The treadmill exercise time was longer than that in the control group (P<0.05), and its 6MWD was higher than that in the control group (P<0.05).Conclusion: Rehabilitation exercise therapy in elderly patients with chronic heart failure can effectively improve the cardiac function, enhance their exercise endurance and energy metabolism level, and improve the clinical efficacy and quality of life.

Clinical effect of sodium hyaluronate joint cavity filling combined with exercise therapy on patients with post-traumatic knee arthritis

Objective:To research the sodium hyaluronate joint cavity filling combined with exercise therapy on the indicator of pain,motor function,and levels of inflammatory factors in joint fluid in patients with post-traumatic knee arthritis.Method Totally 100 patients(Department of Orthopaedics,The second Affiliated Hospital to Liaoning University of Chinese Medicine,2013.10-2018.8)with post-traumatic knee arthritis were selected,then they were divided into observation group(n=50)and control group(n=50).The control group was given glucosamine sulfate and sodium hyaluronate joint cavity filling,the observation group was given leg press with visual feedback,they were treated 4 weeks.Assessing the pain degree through visual analog scale(VAS),hospital for special surgery knee score(HSS)as the indicator of motor function,inflammatory factor(TNF-α,IL-6,and IL-8)in the joint fluid.Results The score of VAS were lower than pretherapy(P<0.05),the degree of VAS of observation group were lower than control group(P<0.05).The score of HSS were higher than pretherapy(P<0.05),the degree of VAS of observation group were higher than control group(P<0.05).The inflammatory factor(TNF-α,IL-6,and CRP)in the joint fluid were lower than pretherapy(P<0.05),and the observation group were lower than control group(P<0.05).Conclusions Giving sodium hyaluronate joint cavity filling combined with exercise therapy can improve the function of joint.

Effectiveness of a Group Exercise Class vs. Home Exercise Program as a Follow-up to Physical Therapy for Older Adults with High Fall Risk

This quasi-experimental study compared the results of a traditional model of physical therapy(PT)care to a PT wellness model known as GroupHab.The traditional model included discharge from PT with a home exercise program(HEP)to be self-administered with or without the addition of a community-based exercise program.The wellness model included participation in a PT-designed and supervised group exercise program(GroupHab class)in an outpatient clinical setting following discharge from PT.Independent t-tests were used to compare the number of falls,exercise frequency,and exercise duration between the two groups.A repeated measures,analysis of variance(RM-ANOVA)compared changes in balance confidence scores both within and between groups,and a multivariate analysis of variance(MANOVA)analyzed group differences across multiple quality of life ratings using the SF-20.All data were analyzed at the 0.05 alpha level using SPSS 24 statistical software.Our results showed a significantly greater reduction in recurrent falls among the GroupHab wellness group compared to the HEP group(t=2.811,p=0.009).The resulting odds ratio for subsequent falls was 2.2 among HEP participants and 0.2 among GroupHab participants.Exercise adherence was also greater for those who participated in the GroupHab class.They documented greater exercise frequency(t=-3.253,p=0.002)and more exercise minutes(t=-7.188,p<0.001)than those who participated in the HEP.When comparing changes in the participants’balance confidence,we found an average increase of 5%among GroupHab participants compared to a 6%decrease among HEP participants(F=16.877,p<0.001,power=0.981).Although our multivariate analysis of the SF-20 scores revealed no significant difference overall(F=0.768,p=0.73),the univariate analyses showed significantly greater improvements among GroupHab participants in selected areas of physical function.These results suggest that at-risk older adults who are discharged into a functionally-based group exercise class are less likely to experience recurrent falls and are more likely to have more confidence in their balance than those who are discharged with a standard HEP and/or use of community-based exercise classes.

Aquatic exercise program-modulated oxidative stress markers in patients with Parkinson's disease

Parkinson's disease is a neurodegenerative disease.Oxidative stress,i.e.,the imbalance between the generation of reactive oxygen species and the antioxidant defense capacity of the body,plays an important role in the pathogenesis of this disease.Physical exercise can regulate oxidative stress.The purpose of this study was to analyze the short-and long-term effects of an aquatic exercise program on oxidative stress levels in patients with Parkinson's disease.The aquatic exercise program was carried out during 1 month with two sessions per week(1 hour/session).Blood samples were collected at four different time points:pre-intervention,immediately,48 hours,and 30 days after the first session of aquatic exercise program.Our results revealed that water-based programs modulated antioxidant enzyme activity,increased superoxide dismutase activity,reduced catalase activity,and increased the ratio of superoxide dismutase activity to catalase activity in patients with Parkinson's disease.Compared with pre-intervention and 48 hours after the first session of aquatic exercise program,superoxide dismutase activity was higher and catalase activity was lower immediately and 30 days after the first session.Our results demonstrated that aquatic exercise program could modulate oxidative stress,mainly by the effect of antioxidant enzyme activity.These results could better help understand the target of oxidative stress in Parkinson's disease.This study was approved by the Ethics Committee of Centro Universitário Metodista IPA(approval No.1.373.911)on August 9,2019 and registered with REBEC(registration number:RBR-6 NJ4 MK).

Exercise for tendinopathy

Tendinopathies are one of the most common sports/musculoskeletal injury in modern western societies.Many physiotherapy approaches have been recommended in the literature for the management of tendinopathy.The most effective treatment in the management of tendinopathy is the eccentric training.Load,speed and frequency of contractions are the three principles of eccentric exercises,discussed in this report.However,eccentric training is not effective for all patients withtendinopathy and the effectiveness of this approach when applied as monotherapy is lower than it is applied as part of the rehabilitation process.For this reason,clinicians combine eccentric training with other physiotherapy techniques such as stretching,isometric and lumbar stability exercises,electrotherapy,manual therapy,soft tissue manipulation techniques,taping and acupuncture in the management of tendinopathies.Further research is needed to find out which treatment strategy combined with eccentric training will provide the best results in the rehabilitation of tendinopathy.

Effects of exercise on physical limitations and fatigue in rheumatic diseases

Physical activity covers not just sports but also simple everyday movements such as housework,walking and playing.Regular exercise has a great importance in maintaining good health,indeed inactivity is a risk factor for different chronic diseases.Physical exercise can play a crucial role in the treatment of rheumatic diseases,optimizing both physical and mental health,enhancing energy,decreasing fatigue and improving sleep.An exercise program for patients with rheumatic diseases aims to preserve or restore a range of motion of the affected joints,to increase muscle strength and endurance,and to improve mood and decrease health risks associated with a sedentary lifestyle.In this editorial I describe the benefits of the exercise on physical limitations and fatigue in rheumatic diseases that seem to have a short and long-term effectiveness.A literature review was conducted on Pub Med,Scopus and Google Scholar using appropriate keywords based on the present editorial.

Addition of hip exercises to treatment of patellofemoral pain syndrome:A meta-analysis

AIM:To determine if the addition of hip-strengthening exercises decreases pain and improves function in patients with patellofemoral pain syndrome.METHODS:The authors completed a systematic reviewsearching eight databases(i.e.,Pub Med,Cochrane,CINHAL,MEDLINE,Sports Discus,EMBASE,APTA Hooked on Evidence,and PEDro).Two independent reviewers screened and excluded studies if they did not meet the following inclusion criteria:subjects had a primary diagnosis of patellofemoral pain syndrome(PFPS),intervention group included hip-strengthening exercises,control group included a traditional physical therapy intervention,study included outcome measures of pain and/or function,study used a randomized controlled trial design,PEDro score was ≥ 7,and study was published in a peer-reviewed journal.Primary outcome measures were subjective scales of pain and function.These measures were converted to standardized mean difference [effect size(ES)],and a random-effects model was used to calculate the overall ES.RESULTS:Two hundred eighty-three studies were screened for inclusion in our meta-analysis.Nine studies were deemed suitable for data extraction and analysis.A total of 426 subjects were used in the nine studies.Overall,there was a significant positive effect of hip-strengthening exercises on measures of pain and function in subjects with PFPS(ES = 0.94,P = 0.00004).None of the individual studies had a negative ES,with study ES ranging from 0.35 to 2.59.Because of the high degree of between-study variance(I2 = 76%;Q = 34.0,P < 0.001),subgroup meta-analyses and meta-regressions were performed.None of the potential moderator variables that were investigated(e.g.,outcome type,hip region targeted,duration of treatment) could explain a significant amount of the between-study variance in ES(P ≥ 0.23).CONCLUSION:Overall,the addition of hip-strengthening exercises to traditional physical therapy produced greater improvements in measures of pain and function.