The Effectiveness of Adapted Personalized Motor Activity (AMPA) to Improve Health in Individuals with Mental Disorders and Physical Comorbidities: A Randomized Controlled Trial

Tailored Exercise Intervention in Metabolic Syndrome: Cardiometabolic Improvements Beyond Weight Loss and Diet-A Prospective Observational Study

Background: Metabolic syndrome (MS) is a cluster of cardiovascular and metabolic risk factors that increase the likelihood of both acute events and chronic conditions. While exercise has been shown to improve individual risk factors associated with MS; research on its effects on MS as an integrated condition remains limited. This study aims to evaluate the effectiveness of a 6-month Adapted Personalized Motor Activity (AMPA) program for improving the health outcomes of individuals with MS. Methods: Seventy-one sedentary participants with MS (mean age: 63 ± 9.4 years, 46.5% female) completed a 6-month intervention, incorporating moderate-intensity aerobic and resistance training. Each participant received a personalized exercise plan prescribed by a sports medicine physician. The training was monitored via telemetry to ensure safety. No dietary recommendations were provided during the intervention. Baseline and post-intervention assessments included Cardiopulmonary Exercise Testing (CPET), anthropometric measurements, blood pressure, heart rate, lipid profile (total cholesterol, HDL, LDL, and triglycerides), fasting glucose, and HbA1c. Results: Significant improvements were observed in fasting glucose (-10.6%, p < 0.001), HbA1c (-3.88%, p < 0.001), HDL cholesterol (+20.8%, p < 0.001), LDL cholesterol (-25.1%, p < 0.001), and VO2max (+8.6%, p < 0.001). Systolic and diastolic blood pressure also decreased significantly, with reductions of -12% (p < 0.001) and -5.9% (p < 0.001), respectively. Reductions in weight and waist circumference were statistically significant but modest and clinically irrelevant, showing no correlation with improvements in cardio-metabolic parameters. Logistic regression and correlation matrix analyses were performed to identify key predictors of changes in individual risk factors. Conclusions: While personalized exercise alone may not fully control individual risk factors of metabolic syndrome, its overall effect is comparable to low-intensity pharmacological polytherapy with minimal adverse effects. These benefits appear to be independent of dietary habits, gender, and both baseline and post-intervention physical performance and anthropometric measures.

The challenge of thigh tendon reinjuries: an expert opinion

This review critically examines the issue of thigh tendon reinjury in athletes, drawing on recent advancements and diverse perspectives in sports medicine. The findings underscore the paramount importance of an early and accurate diagnosis, which significantly influences treatment efficacy and rehabilitation outcomes. We explore the intricacies of tendon anatomy and the mechanisms underlying injuries, highlighting how these factors interplay with athlete-specific risk profiles to affect reinjury rates. A major finding from the review is the necessity for individualized rehabilitation approaches that integrate both traditional methods and emerging technologies. These technologies show promise in enhancing monitoring and facilitating precise adjustments to rehabilitation protocols, thus improving recovery trajectories. Additionally, the review identifies a common shortfall in current practices - premature to play (RTP) - which often results from inadequate adherence to tailored rehabilitation strategies or underestimation of the injury's severity. Such premature RTP significantly heightens the risk of further injury. Through this synthesis of contemporary research and expert opinion, the review advocates for a multidisciplinary approach in managing thigh tendon injuries, emphasizing the need for ongoing research to refine RTP criteria and optimize rehabilitation techniques. The ultimate goal is to support athletes in achieving safer and more effective recoveries, thereby reducing the likelihood of tendon reinjury.

Unlocking the potential of artificial intelligence in sports cardiology: does it have a role in evaluating athlete's heart?

The integration of artificial intelligence (AI) technologies is evolving in different fields of cardiology and in particular in sports cardiology. Artificial intelligence offers significant opportunities to enhance risk assessment, diagnosis, treatment planning, and monitoring of athletes. This article explores the application of AI in various aspects of sports cardiology, including imaging techniques, genetic testing, and wearable devices. The use of machine learning and deep neural networks enables improved analysis and interpretation of complex datasets. However, ethical and legal dilemmas must be addressed, including informed consent, algorithmic fairness, data privacy, and intellectual property issues. The integration of AI technologies should complement the expertise of physicians, allowing for a balanced approach that optimizes patient care and outcomes. Ongoing research and collaborations are vital to harness the full potential of AI in sports cardiology and advance our management of cardiovascular health in athletes.

Short-term economic evaluation of physical activity-based corporate health programs: a systematic review

OBJECTIVES

Corporate health programs (CHPs) aim to improve employees' health through health promotion strategies at the workplace. Physical activity (PA) plays a crucial role in primary prevention, leading many companies to implement PA-based CHPs. However, there is limited examination in the scientific literature on whether PA-based CHPs (PA-CHPs) lead to economic benefits. This systematic review aimed to summarize the available literature on the economic aspects of PA-CHPs.

METHODS

A systematic review was conducted to identify studies focused on PA-CHPs targeting healthy sedentary workers and reporting at least one economic outcome, such as return on investment (ROI), costs, or sick leave.

RESULTS

Of 1036 studies identified by our search strategy, 11 studies involving 60 020 participants met the inclusion criteria. The mean (±SD) cost per capita for PA-CHPs was estimated as 359€ (±238€) (95% CI, 357-361€). In 75% of the studies, the net savings generated by PA-CHPs in 12 months were reported, with an average of 1095€ (±865€) (95% CI, 496-1690€). ROI was assessed in 50% of the included studies, with an average of 3.6 (±1.41) (95% CI, 2.19-5.01).

CONCLUSIONS

In addition to promoting a healthy lifestyle, PA-CHPs have the potential to generate significant economic returns. However, the heterogeneity among the existing studies highlights the need for standardization and accurate reporting of costs in future research.

3-Day food record: efficacy in patients with type 2 diabetes mellitus

OBJECTIVES

This study aimed to assess the efficacy of the 3-day food records in monitoring and enhancing dietary habits among patients with type 2 diabetes mellitus.

METHODS

A total of 49 patients with type 2 diabetes mellitus were enrolled, with 38 completing the study. Participants were instructed to record their food intake over 3 consecutive days every 2 months. Key anthropometric and glycometabolic parameters, including body weight, abdominal circumference, glycated hemoglobin, and fasting blood sugar, were evaluated at baseline and after 6 months.

RESULTS

The introduction of the 3-day food records led to significant improvements in body weight, abdominal circumference, glycated hemoglobin, and fasting blood sugar. Additionally, there was a notable increase in the percentage of patients adhering to the LARN nutritional recommendations, especially concerning the intake of carbohydrates, simple sugars, proteins, fiber, and water. However, adherence to lipid and saturated fat recommendations remained a challenge.

CONCLUSIONS

The 3-day food records emerges as a valuable tool in the dietary management of patients with type 2 diabetes mellitus. By facilitating real-time monitoring and feedback, it holds promise in enhancing patient adherence to nutritional guidelines, thereby improving key health outcomes.

Effects of traditional Chinese exercises on cardiac rehabilitation in patients with myocardial infarction: a meta-analysis of randomized controlled trials

Objective

Traditional Chinese exercises (TCE) are excellent cardiac rehabilitation (CR) training that can effectively improve cardiorespiratory fitness. However, there is no published meta-analysis of TCE on CR in patients with myocardial infarction (MI). Therefore, this study aimed to provide a comprehensive evaluation from multiple perspectives.

Methods

This meta-analysis is based on the Cochrane Handbook of Systematic Reviews. Eight databases were searched from the date of database construction to March 15, 2023. Two investigators independently screened the literature and assessed their quality. The meta-analysis was performed with RevMan5.4 software.

Results

A total of 21 articles involving 1,890 patients were included. N-terminal pro-brain natriuretic peptide (NT-proBNP) in the TCE group were lower than the control group (MD = -96.34, 95%CI: -140.69 ∼-51.98, P < 0.00001, I2 = 96%), the left ventricular ejection fraction (LVEF) in the TCE group was higher than the control group (MD = 4.58, 95%CI: 3.28-5.88, P < 0.00001, I2 = 79%), the left ventricular end diastolic dimension (LVDD) in TCE group was lower than the control group (MD = -3.83, 95%CI: -5.27 ∼-2.38, P < 0.00001, I2 = 94%), the left ventricular end systolic diameter (LVESD) in TCE group was lower than the control group (MD = -2.17, 95%CI: -4.10 ∼-0.24, P < 0.00001, I2 = 96%), The 6-minute walk test (6MWT) in the TCE group was higher than the control group (MD = 69.60, 95%CI: 34.59-104.60, P < 0.00001, I2 = 99%), the oxygen uptake (VO2) in the TCE group was higher than the control group (MD = 4.38, 95%CI: 2.25-6.51, P < 0.00001, I2 = 94%), the 36-item short form survey (SF-36) in the TCE group was higher than the control group (MD = 13.34, 95%CI: 9.25-17.42, P = 0.008, I2 = 75%), the Hamilton Anxiety Scale (HAMA) in the TCE group was lower than the control group (MD = -4.34, 95%CI: -5.18 ∼-3.50, P = 1.00, I2 = 0%), the Hamilton Depression Scale (HAMD) in the TCE group was lower than the control group (MD = -3.48, 95%CI: -5.35 ∼-1.61, P = 0.0002, I2 = 88%), the incidence of major adverse cardiac events (MACEs) in the TCE group was lower than the control group (RR = 0.31, 95%CI: 0.20-0.47, P = 0.52, I2 = 0%). Subgroup analysis revealed differences in TCE types could be a potential source of heterogeneity.

Conclusion

MI patients who used TCE have not only notable improvements in cardiopulmonary function, physical function, quality of life, and emotions but also reduced the incidence of MACEs. Tai Chi might be more efficient than Ba Duan Jin.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023408675.

Age, sex, endurance capacity, and chronic heart failure affect central and peripheral factors of oxygen uptake measured by non-invasive and continuous technologies: support of pioneer work using invasive or non-continuous measures

Introduction

It is known that maximum oxygen uptake depends on age, sex, endurance capacity, and chronic heart failure. However, due to the required invasive or often applied non-continuous approaches, less is known on underlying central and peripheral factors. Thus, this study aimed to investigate the effects of age, sex, endurance capacity, and chronic heart failure on non-invasively and continuously measured central and peripheral factors of oxygen uptake.

Methods

15 male children (11 ± 1 years), 15 male (24 ± 3 years) and 14 female recreationally active adults (23 ± 2 years), 12 male highly trained endurance athletes (24 ± 3 years), and 10 male elders (59 ± 6 years) and 10 chronic heart failure patients (62 ± 7 years) were tested during a cardiopulmonary exercise test on a cycling ergometer until exhaustion for: blood pressure, heart rate, stroke volume, cardiac output, cardiac power output, vastus lateralis muscle oxygen saturation, and (calculated) arterio-venous oxygen difference. For the non-invasive and continuous measurement of stroke volume and muscle oxygen saturation, bioreactance analysis and near-infrared spectroscopy were used, respectively. A two-factor repeated measure ANOVA and partial eta-squared effect sizes (η p 2 ) were applied for statistical analyses at rest, 80, and 100% of oxygen uptake.

Results

For the age effect, there were statistically significant group differences for all factors (p ≤ .033; η p 2 ≥ .169 ). Concerning sex, there were group differences for all factors (p ≤ .010; η p 2 ≥ .223 ), except diastolic blood pressure and heart rate (p ≥ .698; η p 2 ≤ .006 ). For the effect of endurance capacity, there were no group differences for any of the factors (p ≥ .065; η p 2 ≤ .129 ). Regarding chronic heart failure, there were group differences for the heart rate and arterio-venous oxygen difference (p ≤ .037; η p 2 ≥ .220 ).

Discussion

Age, sex, endurance capacity, and chronic heart failure affect central and peripheral factors of oxygen uptake measured by non-invasive and continuous technologies. Since most of our findings support pioneer work using invasive or non-continuous measures, the validity of our applied technologies is indirectly confirmed. Our outcomes allow direct comparison between different groups serving as reference data and framework for subsequent studies in sport science and medicine aiming to optimise diagnostics and interventions in athletes and patients.

Athlete's Heart: A Cardiovascular Step-By-Step Multimodality Approach

"Athlete's heart" is a spectrum of morphological, functional, and regulatory changes that occur in people who practice regular and long-term intense physical activity. The morphological characteristics of the athlete's heart may overlap with some structural and electrical cardiac diseases that may predispose to sudden cardiac death, including inherited and acquired cardiomyopathies, aortopathies and channelopathies. Overdiagnosis should be avoided, while an early identification of underlying cardiac life-threatening disorders is essential to reduce the potential for sudden cardiac death. A step-by-step multimodality approach, including a first-line evaluation with personal and family history, clinical evaluation, 12-lead resting electrocardiography (ECG), followed by second and third-line investigations, as appropriate, including exercise testing, resting and exercise echocardiography, 24-hour ECG Holter monitoring, cardiac magnetic resonance, computed tomography, nuclear scintigraphy, or genetic testing, can be determinant to differentiate between extreme physiology adaptations and cardiac pathology. In this context, cardiovascular imaging plays a key role in detecting structural abnormalities in athletes who fall into the grey zone between physiological adaptations and a covert or early phenotype of cardiovascular disease.

Single 30 min treadmill exercise session suppresses the production of pro-inflammatory cytokines and oxidative stress in obese female adolescents

OBJECTIVES

Regular treadmill exercise may result in changes in pro-inflammatory cytokines and oxidative stress. However, the way acute treadmill exercise mechanisms affect the changes in pro-inflammatory cytokines and oxidative stress in obese has not been comprehensively exposed. This study aimed to analyze the pro-inflammatory cytokines and oxidative stress between 30 min before treadmill exercise and 24 h after treadmill exercise in obese adolescents.

METHODS

A total of 20 obese females aged 19-24 years were recruited from female students and given one session of treadmill exercise with an intensity of 60-70% HR_max. Thiobarbituric acid reactive substance (TBARS) was used to analyze serum levels of MDA, while enzyme-linked immunosorbent assay (ELISA) was used to analyze serum levels of TNF-α and IL-6. Moreover, the independent samples t-test with a significance level of 5% was employed to have the statistical analysis.

RESULTS

The results on 24 h after treadmill exercise and delta (Δ) between CTRL and TREG showed a significant difference (p<0.001).

CONCLUSIONS

This study found a decrease in pro-inflammatory cytokines and oxidative stress 24 h after treadmill exercise in obese adolescents. Therefore, treadmill exercise can be a promising strategy for preventing adolescents from obesity as well as preventing disease risks associated with oxidative stress and chronic inflammation.

The eSports Medicine: Pre-Participation Screening and Injuries Management-An Update

Recently, electronic sports (eSports) became one of the growing forms of new media due to the wide diffusion of games and online technologies. Even if there is still a debate about the definition and characterization of eSports, eAthletes train heavily, compete in tournaments, must abide by competition, association, and governing body rules, just like all other athletes. Furthermore, as in any other competitive discipline, there can be injuries. Aberrant sitting posture, repetitive movements, screen vision, prolonged playing hours, and a sedentary lifestyle can lead to several medical hazards in musculoskeletal, ophthalmology, neurological, and metabolic systems. Moreover, several cardiovascular changes occur in eAthletes. This paper aims to explore the different injuries that can occur in a professional eAthlete, suggesting how every high-level gamer could benefit from a pre-participation evaluation and a correct injury prevention strategy.

Selective Functional Movement Assessment (SFMA) Reliability and Proposal of Its Use in Sports

INTRODUCTION

The Selective Functional Movement Assessment (SFMA) is a functional movement assessment method to observe movement restrictions in individuals with known musculoskeletal disorders, although it has also been used to evaluate healthy athletes of different sports.

AIM

The present paper aimed to evaluate the applicability of SFMA in a clinical setting and to verify whether a student can correctly perform it.

METHODS

An introductory and explanatory email was sent to the subjects, containing the instructions needed to produce a video with SFMA evaluation movements. SFMA methodology was then used to analyze the received videos. The results between interobserver and intraobserver agreement were compared to the literature, considered the gold standard methods.

RESULTS

Twenty-eight subjects (17.71 ± 1.96 years aged) were rated. The functional non-painful scenario (FN) has been assigned more frequently by all raters. The student's intra-rater reliability proved to be moderate (Kappa coefficient 0.49). Results for inter-rater reliability showed that the reliability degree between the senior physiotherapist and student before and after their educational path is good (Kappa coefficient 0.60 and 0.62, respectively).

CONCLUSIONS

The results of this study showed SFMA intra-rater reliability to be moderate, while inter-rater reliability can be considered good. These characteristics make it a valuable tool for sport's needs, even when used by students.

The Effects of Yoga Exercise on Blood Pressure and Hand Grip Strength in Chronic Stroke Patients: A Pilot Controlled Study

BACKGROUND

We investigated the beneficial effect of add-on yoga with rehabilitation on blood pressure (BP) and hand grip strength in patients with chronic stroke (more than 90 days).

METHODS

The study included patients 30-80 years of age who could stand independently for 1 min. Patients with psychiatric diseases or undergoing other therapies (like acupuncture) were excluded. The yoga group received training (1 h session twice weekly) with standard rehabilitation for 8 weeks. The control group received standard rehabilitation only. There were no differences in age, gender, hand grip strength, or BP between the two groups (16 subjects in each group) at baseline.

RESULTS

The systolic BP (p = 0.01) decreased significantly, and the diastolic BP also decreased but not significantly in the yoga group (p = 0.11). For hand grip strength, both the unaffected hand (p = 0.00025) and the affected hand (p = 0.027) improved significantly. The control group showed no significant change in systolic or diastolic BP, nor did the grip strength change in both hands. Gender and age also affected the results of overall rehabilitation in that women benefited more from a decrease in BP, while men and young people (lower than the mean age of 60) benefited from hand grip strength improvement.

CONCLUSIONS

Combining yoga with rehabilitation in chronic stroke patients can improve hand grip strength and decrease systolic BP.

Physiological response of endurance exercise as a growth hormone mediator in adolescent women's

OBJECTIVES

Overweight status decreases the growth hormone (GH) secretion, thus, increasing the risk factors for medical complications. However, proper exercise is reported to enhance GH and affect the energy balance. Therefore, exercise is proclaimed to be an accurate and engaging therapy to increase GH in preventing overweight. This study aims to investigate the physiological response of exercise in mediating the increase of GH secretion in female adolescents.

METHODS

22 overweight women aged 19-20 years old, with maximal oxygen consumption of 27-35 mL/kg/min, were selected as sample size. They were divided into three groups, namely (CONT, n=7) Control, (MIEE, n=7) Moderate-intensity interval endurance exercise, and (MCEE, n=8) Moderate-intensity continuous endurance exercise. The exercise was carried out by running for 30-35 min using treadmills with an intensity of 60-70% HR_max. The blood sampling for GH examination was carried out four times before exercise, 10 min, 6 h, and 24 h after exercise. The enzyme-linked immunosorbent assay (ELISA) was used to measure the GH and IGF-1 levels. The data analysis was carried out using a one-way ANOVA test, with a significance level of 5%.

RESULTS

The results of the one-Way ANOVA test suggested a significantly different average GH and IGF-1 before and after the exercise between the three groups (CON, MIEE, and MCEE) (p≤0.05).

CONCLUSIONS

MCEE increases the GH and IGF-1 levels more considerably than MIEE. Therefore, exercise is a mediator to increase GH and IGF-1 secretion in overweight individuals. Exercise could be a viable therapy for overweight people.

Physical activity can reduce hopelessness among women admitted to psychiatric short stay unit following a suicide crisis

BACKGROUND

In a growing number of countries, brief hospitalizations in psychiatric short stay units (SSUs) are proposed to patients in acute mental health crisis (typically suicide crisis).

AIMS

This pilot study's purpose was to assess the feasibility, acceptability, and plausible efficacy of two days of 30 min of brisk-walking/jogging compared to 30 min of sedentary activities in suicidal inpatients from a French psychiatric SSU.

METHODS

Twelve female adults completed the study. Participants in the brisk-walking/jogging group (n = 6) received two exercise sessions of 30 min separated by a time interval of 24 h. Participants in the control group (n = 6) did not receive the exercise intervention, but were asked to engage in sedentary activities of similar duration at the same time of the day. Measures of hopelessness and optimism/pessimism were administered at the intake and final assessments. In addition, other performance indicators were explored and provide the readers with information about the feasibility and acceptability of intervention.

RESULTS

Findings showed strong feasibility and acceptability (no serious adverse event, adherence and retention rates around 75%-80%, and high patients satisfaction ratings). Significant differences between groups favoring women who exercised were oberved in the score change of hopelessness (Hedges's g = -1.29, 95% CI [-2.65, -0.08]).

CONCLUSION

The present study provides preliminary evidence for the plausible adjunctive efficacy of physical activity to alleviate the psychological distress suffered by suicidal patients in a psychiatric SSU.

The Acute-Phase Ambulation Program Improves Clinical Outcome for Acute Heart Failure

It remains unclear whether the acute-phase ambulation program (AAP) improves the prognosis of heart failure (HF) patients. We examined the association between the initiation of AAP and the prognosis of patients with worsening HF. We enrolled 560 consecutive patients admitted due to worsening HF from March 2019 to April 2021. Our hospital introduced AAP in May 2020, but we did not perform AAP until April 2020. We retrospectively compared cardiac events within 180 days after discharge between patients admitted before April 2020 (conventional group) and after May 2020 (AAP group). Primary endpoints were all-cause mortality and readmission for worsening HF. The Kaplan–Meier survival curves showed a significantly lower event rate in the AAP group in HF readmission or the primary endpoint (p = 0.020 and p = 0.014). The occurrence of the primary endpoint was associated with age, history of HF, systolic blood pressure, medications including renin–angiotensin system inhibitors or angiotensin receptor blocker, hemoglobin, NT-proBNP, and AAP participation. After adjusting for these parameters and sex, participation in AAP was an independent factor associated with a reduced risk of primary endpoint occurrence (hazard ratio of 0.62 (0.41–0.95), p = 0.028). The AAP for patients with acute HF might lead to improved short-term prognosis and should be considered for implementation.

Impact of mental toughness on athlete's performance and interventions to improve

Mental toughness is the ability to handle pressure, adversity, and stress by overcoming failures. It is also the state of persisting without refusing to quit, with the possession of superiority in mental skills. This review aimed to describe the effect of mental toughness on the performance of athletes and also to have an insight into the various interventions to improve mental toughness. For this, PubMed was searched using the appropriate keywords till December 2021 and a narrative synthesis was performed. Mental tightness was evident to be correlated with many important aspects such as better performance, goal progress, withholding stress, coping, optimism and self-reflection. It also helps in a better level of confidence, constancy, control, positive cognition, visualization and challenges than the opponent team. Many interventional strategies have been adopted in previous years which mainly focused on personalized programs including psychological skills training, coping and optimism training, mindfulness, yoga, general relaxation, imagery, and a combination of both, and many more other aspects were observed to be effective in improving mental toughness. However, physical training alone did not observe to be beneficial. The current evidence indicates the important role of mental toughness on the sports performance of athletics and the role of various interventional strategies focusing on mindfulness and psychological interventions in improving mental toughness. All these interventional strategies need to be implemented in the actual practice.