Wii-based exercise program to improve physical fitness, motor proficiency and functional mobility in adults with Down syndrome

BACKGROUND

People with Down syndrome (DS) usually display reduced physical fitness (aerobic capacity, muscle strength and abnormal body composition), motor proficiency impairments (balance and postural control) and physical functional limitations. Exergames can be an appealing alternative to enhance exercise engagement and compliance, whilst improving physical fitness and motor function. This study aims to analyse the effects of a Wii-based exercise program on physical fitness, functional mobility and motor proficiency of adults with DS.

METHODS

Twenty-seven adults with DS were randomly allocated to an experimental group (Wii; n = 14) or control group (n = 13). Participants in the experimental group completed a 2-month Wii-based exercise program, with three 1-h sessions per week that included training games for aerobic endurance, balance and isometric strength. Participants completed assessments regarding anthropometric measures, physical fitness, functional mobility and motor proficiency.

RESULTS

Mixed ANOVA analysis showed a significant group by time interaction for aerobic endurance, explosive leg power and flexibility. Independent samples t-test for change scores indicated significant between-group differences favouring the experimental group regarding speed of limb movement, trunk strength and functional mobility, as well as a trend towards significance on body weight. Mann-Whitney's U test for change scores demonstrated between-group differences favouring the experimental group for visceral fat as well as running speed and agility. Large within-group effect sizes were observed for explosive leg power (d = 1.691), body weight (d = 1.281), functional mobility (d = 1.218), aerobic endurance (d = 1.020), speed of limb movement (d = 0.867) and flexibility (d = 0.818) in the experimental group.

CONCLUSIONS

Our findings suggest that Wii-based exercise can be an effective tool to improve physical fitness, functional mobility and motor proficiency of adults with DS, including crucial measures such as aerobic capacity and lower limb strength. Exergames using Wii Fit or other equipment can be appealing alternatives for adults with DS to engage in regular physical activity, preventing sedentary behaviour and decreasing the risk to develop cardiovascular diseases.

Efficacy and safety of cetuximab, oxaliplatin, and capecitabine as first-line therapy for metastatic colorectal cancer (mCRC): Results of a phase II study

e15013

Background: To date, few studies have investigated the use of cetuximab in combination with oxaliplatin and capecitabine in the first-line treatment of mCRC. We therefore conducted an uncontrolled, open-label, multicenter study to evaluate the efficacy and safety of this combination in this setting. Methods: Patients (pts) received intravenous (iv) oxaliplatin 130 mg/m2 (3h day 1) plus capecitabine 1,000 mg/m2 twice daily (days 1–14) every 3 weeks (XELOX) and cetuximab 400 mg/m2 iv week 1 then 250 mg/m2 weekly over 8 cycles. Treatment was continued until disease progression (PD), unacceptable toxicity or completion of therapy. Pts were followed until death. The primary endpoint was overall response rate (ORR). A sample size of 45 pts was necessary to obtain a 95% confidence interval (CI) for ORR with a maximum width of 15% assuming an ORR of 50–80%. Results: From Sept 2005-Jan 2007, 49 pts were enrolled (ITT population): 67% male, mean age 60 (range: 44–75) years, 56.3% ECOG PS 0. Of 42 pts evaluable for ORR, 4 (9.5%) achieved a complete response, 31 (73.8%) a partial response, 6 (14.3%) had stable disease and 1 (2.4%) had PD. The ORR was 83.3% (95% CI: 72.0–94.6%). Median time to progression was 9 months (95% CI: 7.1–10.9 months). Of the 49 pts evaluable for safety, 27 (55.1%) had at least one grade 3/4 toxicity, 42 (85.7%) had acne-like rash (8 pts [16.3%] grade 3). Most common grade 3/4 toxicities included diarrhea (n=9;18.4%) and changes in potassium (n=6;12.2%). 24 (3.4%) AEs led to dose reductions (12 unrelated, 10 unlikely and 2 definitely related to cetuximab), 56 (7.8%) led to a dose delay (12 unrelated, 28 unlikely, 8 possibly, 6 probably, 2 definitely related to cetuximab) and 2 (0.3%) led to infusion rate reduction (not treatment related). 27 (55.1%) pts discontinued therapy: 10 (20.4%) due to AEs, 7 (14.3%) PD, 10 (20.4%) other reasons. 33 (67.3%) pts died: 30 (61.2%) due to PD, 2 (4.1%) intercurrent event/disease, 1 (2.0%) acute pancreatitis. The results according with the HGFR evaluation by IHC will be presented. Conclusions: In this first-line mCRC study, 83.3% of pts treated with cetuximab, oxaliplatin and capecitabine achieved an overall response. This combination appears to be a highly active and well-tolerated regimen.

No significant financial relationships to disclose.

A whole genome screen for association with multiple sclerosis in Portuguese patients

Multiple sclerosis (MS) is common in Europe affecting up to 1:500 people. In an effort to identify genes influencing susceptibility to the disease, we have performed a population-based whole genome screen for association. In this study, 6000 microsatellite markers were typed in separately pooled DNA samples from MS patients (n=188) and matched controls (n=188). Interpretable data was obtained from 4661 of these markers. Refining analysis of the most promising markers identified 10 showing potential evidence for association.

[Primary neoplasm of unknown origin]

Cancers of unknown primary site constitute a heterogeneous group having in common their biological behaviour. We have analysed patients with cancer of unknown primary site admitted to University Hospital of Coimbra/Internal Medicine Service III from 1st January of 1992 to 30th June of 1998. The study included 26 patients corresponding to a prevalence of 2.5% malignant neoplasias; the median age of affected patients was 64 years old with a male-to-female ratio of 4.2:1. The most frequent histological type was well differentiated and moderately well differentiated adenocarcinoma, 46.1% of all cases. Three years global survival rate was 3.9%. The herein-reported prevalence is comparable to that found in recent literature, showing a good diagnostic skill. As expected, the prognosis was poor, revealing the disease's aggressiveness and the lack of efficient therapy in the majority of case.

[Acute complications of diabetes mellitus]

A retrospective study was made of 83 diabetic patients admitted to the Department of Internal Medicine between January 1986 and December 1993, with acute intercurrence of the disease. The authors considered some clinical features (age, type and frequency of complication, form of presentation, causal aetiology, laboratory findings and therapeutic options). Statistical relationships between different populations were made using the unpaired Student's T. method. Results were compared with those in the literature, leading to some significant conclusions.

[Anorexia nervosa in a patient with type-1 diabetes mellitus]

Female patient, 21 years of age, with diabetes mellitus type I, admitted due to progressive weight loss, with a recent history of impaired glycemic control, ketosis and amenorrhea for 12 months. Studies were conducted in order to exclude an endocrine or malignant disorder. After nutritional, endocrine and psychiatric evaluation, the diagnosis of anorexia nervosa, was made. Therapeutic results and clinical course after the first year are shown. The case raises important problems, especially within diabetic population, puzzling the clues for diagnosis and therapy.

[Adrenal gland adenoma sensitive to renin]

Aldosterone-producing adenomas responsive to renin are an extremely rare subgroup of primary hyperaldosteronism and raise some diagnostic problems. In reference to the presentation of one case, some theoretical considerations regarding diagnosis are made.