Effect of whole-body vibration stimulation on plasma soluble TNF receptors in elderly with sarcopenia: a randomized controlled trial

Sarcopenia is a pathology resulting from a progressive and severe loss of muscle mass, strength, and function in the course of aging, which has deleterious consequences on quality of life. Among the most widespread studies on the issue are those focused on the effect of different types of physical exercise on patients with sarcopenia. This randomized controlled study aimed to compare the effects of a whole-body vibration exercise (WBV) session on the inflammatory parameters of non-sarcopenic (NSG, n=22) and sarcopenic elderly (SG, n=22). NSG and SG participants were randomly divided into two protocols: intervention (squat with WBV) and control (squat without WBV). After a one-week washout period, participants switched protocols, so that everyone performed both protocols. Body composition was assessed by dual-energy radiological absorptiometry (DXA) and function through the six-minute walk test (6MWD) and Short Physical Performance Battery (SPPB). Plasma soluble tumor necrosis factor receptors (sTNFR) were determined by enzyme-linked immunosorbent assay (ELISA) and measured before and immediately after each protocol. After exercise with WBV, there was an increase in sTNFR2 levels in the NSG (P<0.01; d=-0.69 (-1.30; -0.08) and SG (P<0.01, d=-0.95 (-1.57; -0.32) groups. In conclusion, an acute session of WBV influenced sTNFr2 levels, with sarcopenic individuals showing a greater effect. This suggested that WBV had a more pronounced impact on sTNFr2 in those with loss of muscle strength and/or physical performance. Additionally, WBV is gaining recognition as an efficient strategy for those with persistent health issues.

Functional tests associated with sarcopenia in moderate chronic obstructive pulmonary disease

Objectives: To evaluate the association of physical and functional measures with sarcopenia in moderate chronic obstructive pulmonary disease (COPD) and to establish cutoff points for sarcopenia screening.Methods: The study included COPD with and without sarcopenia, of both sexes who were over 50 years old. Participants were assessed for lung function, body composition, grip strength, Short Physical Performance Battery (SPPB), 5-repetition, 10-repetition and 30-s sit-to-stand tests (5STS, 10STS, and 30STS, respectively). In addition, 6-min walking test, respiratory muscular strength, and physical activity level were tested.Results: The study had 35 participants, 24 men (68.6%) and moderate COPD (51.4%). COPD-sarcopenia showed lower values in lean mass, body fat and body mass alongside lower performance in 10 and 30 STS tests, SPPB and gait speed compared to non-sarcopenic group. The cutoff points with better sensitivity and specificity to identify sarcopenia were 10.88 and 34.14 s, 15 repetitions, and 10 points in the 5STS, 10STS, 30STS, and SPPB, respectively. The comparison of the receiver operating curves evidenced no differences between the functional tests. Only 30STS and SPPB showed acceptable discriminatory power.Conclusion: Functional tests, especially 30STS and SPPB, are simple and affordable tools for screening sarcopenia in COPD with moderate obstruction.

Strategies to facilitate access to physical activity on a basic health unit: A participatory design

Background

sedentary lifestyle has been decreasing physical activity (PA) practice, accentuating the prevalence of overweight and obesity. Participatory methods in healthcare (including Design Thinking) have been proposed to obtain input from users, creating critical strategies for patients and physicians. The aim of this study was to elaborate strategies to facilitate access to PA for users from a basic health unit (BHU) by means of a participatory design.

Methods

a qualitative, participatory design with Design Thinking was carried out in a BHU at Nova Friburgo (Brazil), serving a community with 1,131 families. Semi-structured interviews were conducted with 32 users, and four health community agents (CHAs). Immersion and ideation (Design Thinking) were applied: (1) to gather information about PA; (2) to map free PA sites; (3) to develop generation sessions with users and CHAs, gathering information about needs, barriers and desires, and creating strategies to provide free PA.

Results

data showed that 59% of the users do not regularly practice PA. They reported lack of time, laziness, health problems, location and cost. CHAs said that they are not prepared to give information to users about PA. CHAs and users declared that they use mobile apps, and an app about PA would be helpful. According to them, the access for PA would be facilitated with: free offering, places near the community, CHA capacitation, professional advisement for exercise at home, and a mobile app with maps and transportation options, schedules, exercise programs and health education.

Conclusions

it was possible to propose strategies to facilitate access to PA by means of a participatory process (Design Thinking) with CHAs and HBU users. As a consequence, there is already a private financing support for a mobile app, as well as the preparation of a report to be presented to the city's secretary of health. It is expected to further benefit not only the local community, but the entire city.

Key messages

A participatory design with Design Thinking provided strategies to facilitate access to physical activity for users from a health basic unit. The development of a mobile app with information about PA access for underserved community seems to be an interesting option to foster exercise practice on a regular basis.

Acute and Cumulative Effects With Whole-Body Vibration Exercises Using 2 Biomechanical Conditions on the Flexibility and Rating of Perceived Exertion in Individuals With Metabolic Syndrome: A Randomized Clinical Trial Pilot Study

This study evaluated the effects of 6 weeks of whole-body vibration (WBV) exercise on flexibility and the rating of perceived exertion (RPE) in metabolic syndrome (MetS) individuals using 2 biomechanical conditions (fixed frequency [FF] and variable frequency [VF]). Nineteen MetS individuals were randomly allocated in FF-WBV (n = 9, 7 women and 2 men) and VF-WBV (n = 10, 8 women and 2 men) groups. Anterior trunk flexion (ATF) and RPE were determined before and after each session. The acute cumulative exposure effects were analyzed. The FF-WBV group was exposed to 5 Hz on a side alternating vibrating platform (SAVP), exposed to 10 and 50 seconds with the SAVP turned off. The VF-WBV group individuals were intermittently exposed (1 minute WBV exercise/1 minute rest) to 5 to 16 Hz, increased by 1 Hz per session and the peak-to-peak displacement (PPD) were 2.5, 5.0, and 7.5 mm. Regarding to ATF, significant improvements (P < .05) were observed in the in the acute (VF group) and cumulative intervention (FF and VF-WBV groups). The RPE significantly (P < .05) improved only in VF-WBV (cumulative intervention). In conclusion, WBV exercise improved the flexibility and decreased the RPE in MetS individuals. These findings suggest that WBV exercise can be incorporated into physical activities for MetS individuals.

Aerodynamic investigation of the thermo-dependent flow structure in the wake of a cyclist

The main purpose of this study was to assess the influence of the environmental temperature on both the aerodynamic flow evolving around the bicycle and cycling power output. The CFD method was used to investigate the detailed flow field around the cyclist/bicycle system for a constant speed of 11.1 m/s (40 km/h) without wind. In complement, a mathematical model was used to determine the temperature-dependent power output in the range [-10; 40 °C]. The numerical investigation gives valuable information about the turbulent flow field in the cyclist's wake which evolves accordingly the surrounding temperature. A major result of this study is that the areas of overpressure upstream of the cyclist and of underpressure downstream of him are less extensive for a temperature of 40 °C compared to -10 °C. The results suggest that the aerodynamic braking effect of the bicycle is minimized when the air temperature is high, as a lower air density results in a reduction in drag on the cyclist. This study showed that the power required to maintain a constant speed is reduced when the temperature is high, the reason being a lower aerodynamic resistance.

Aerodynamic study of time-trial helmets in cycling racing using CFD analysis

The aerodynamic drag of three different time-trial cycling helmets was analyzed numerically for two different cyclist head positions. Computational Fluid Dynamics (CFD) methods were used to investigate the detailed airflow patterns around the cyclist for a constant velocity of 15 m/s without wind. The CFD simulations have focused on the aerodynamic drag effects in terms of wall shear stress maps and pressure coefficient distributions on the cyclist/helmet system. For a given head position, the helmet shape, by itself, obtained a weak effect on a cyclist's aerodynamic performance (<1.5%). However, by varying head position, a cyclist significantly influences aerodynamic performance; the maximum difference between both positions being about 6.4%. CFD results have also shown that both helmet shape and head position significantly influence drag forces, pressure and wall shear stress distributions on the whole cyclist's body due to the change in the near-wake behavior and in location of corresponding separation and attachment areas around the cyclist.

Medical Infrared Thermography assistance in the surgical treatment of axillary Hidradenitis Suppurativa: A case report

BACKGROUND

The purpose of this case report is to highlight for the first time the way Medical Infrared Thermography can be a helpful tool to assist the surgeon in the surgical treatment of Hidradenitis Suppurativa inflammatory disease.

METHODS

A 36-year-old man with a 7-year history of Hidradenitis Suppurativa presented inflammatory nodules in the left axilla area corresponding to Hurley stage II. Choice is made to surgically treat this patient using a wide excision protocol combined with a postoperative second intention healing. For the study purpose, an IR FLIR SC620 camera (FLIR Systems, Wilsonville, OR), having a high resolution pixel detector of 640×480 pixels for greater accuracy and higher resolution, has been used.

RESULTS

For the first time in the literature, this case report on HS disease supports the idea that real-time medical infrared thermography may be helpful in establishing the true extent of disease preoperatively in the surgical room and in a similar manner, that this technique allows the surgeon to ensure all diseased lesions are removed during surgery.

CONCLUSIONS

At least, medical infrared thermography seems to be a powerful tool to control the final wide surgical wound, in order to minimize recurrence risk of such a disease.

Reliability and validity of an accele-rometric system for assessing vertical jumping performance

The validity of an accelerometric system (Myotest©) for assessing vertical jump height, vertical force and power, leg stiffness and reactivity index was examined. 20 healthy males performed 3ד5 hops in place”, 3ד1 squat jump” and 3× “1 countermovement jump” during 2 test-retest sessions. The variables were simultaneously assessed using an accelerometer and a force platform at a frequency of 0.5 and 1 kHz, respectively. Both reliability and validity of the accelerometric system were studied. No significant differences between test and retest data were found (p < 0.05), showing a high level of reliability. Besides, moderate to high intraclass correlation coefficients (ICCs) (from 0.74 to 0.96) were obtained for all variables whereas weak to moderate ICCs (from 0.29 to 0.79) were obtained for force and power during the countermovement jump. With regards to validity, the difference between the two devices was not significant for 5 hops in place height (1.8 cm), force during squat (-1.4 N · kg⁻¹) and countermovement (0.1 N · kg⁻¹) jumps, leg stiffness (7.8 kN · m⁻¹) and reactivity index (0.4). So, the measurements of these variables with this accelerometer are valid, which is not the case for the other variables. The main causes of non-validity for velocity, power and contact time assessment are temporal biases of the takeoff and touchdown moments detection.

Analysis of wall shear stress around a competitive swimmer using 3D Navier-Stokes equations in CFD

This paper deals with the flow dynamics around a competitive swimmer during underwater glide phases occurring at the start and at every turn. The influence of the head position, namely lifted up, aligned and lowered, on the wall shear stress and the static pressure distributions is analyzed. The problem is considered as 3D and in steady hydrodynamic state. Three velocities (1.4 m/s, 2.2 m/s and 3.1 m/s) that correspond to inter-regional, national and international swimming levels are studied. The flow around the swimmer is assumed turbulent. The Reynolds-averaged Navier-Stokes (RANS) equations are solved with the standard k-ω turbulent model by using the CFD (computational fluid dynamics) numerical method based on a volume control approach. Numerical simulations are carried out with the ANSYS FLUENT® CFD code. The results show that the wall shear stress increases with the velocity and consequently the drag force opposing the movement of the swimmer increases as well. Also, high wall shear stresses are observed in the areas where the body shape, globally rigid in form, presents complex surface geometries such as the head, shoulders, buttocks, heel and chest.

Upper-limb motion and drop jump: effect of expertise

AIM

In this study, the role of arm motion in a drop jump was investigated in skilled and unskilled subjects.

METHODS

Nine skilled volleyball players and 8 novice individuals performed a series of jumps from two different heights: 30 cm and 60 cm. Free and restricted arm motion were used to determine the effect of arm motion on the vertical jump. Participants were instructed to land on a force plate and jump as high as possible. The ground reaction force was measured with an AMTI force plate (500 Hz). The kinematics of the jumps was recorded with two digital cameras (50 Hz).

RESULTS

The motion of the arms during the jumps was found to increase the jump height by 15% for the volleyball players and 12% for unskilled jumpers. Volleyball players performed better in the 60 cm than in 30 cm drop height (+8.5%). In the volleyball players, the peak vertical ground reaction force during take-off increased by 7%, the peak power increased by 10.6% while the peak impact force decreased by 6.3%.

CONCLUSIONS

Skilled jumpers were found to have a better use of arm motion than novices in (i) increasing the vertical jump performance, (ii) controlling the balance of the body at take-off (iii) leaving the ground with an optimal body orientation.

Differences between sprint tests under laboratory and actual cycling conditions

AIM

The aim of this study was to compare the maximal power output (POpeak) and force-velocity relationships in sprint cycling obtained from a laboratory protocol and from a field test during actual cycling locomotion.

METHODS

Seven male competitive cyclists performed 6 sprints (3 in the seated position and 3 in the standing position) on an ergo-trainer (Tacx, Netherlands) and 6 sprints during actual cycling locomotion in a gymnasium. The bicycle was equipped with the SRM Training System (Schoberer Rad Messtechnik, Germany) to measure (200 Hz) the power output (PO, W), the pedalling cadence (rpm), and the velocity (kmxh-1). From these measurements, the maximal force on the pedal (Fmax), the theoretical maximal force (Fo, N) and the theoretical maximal pedalling cadence (V0, rpm) were determined. During each sprint test the lateral bicycle oscillations were measured from a video analysis.

RESULTS

During standing and seated sprints in the gymnasium, Fo and Fmax were significantly higher (p<0.05) compared with sprints on the ergo-trainer (+12% and +32%, respectively). The POpeak during sprints in seated and standing positions in the gymnasium was significantly (p<0.05) lower (-4%) and higher (+6%) respectively, compared with the ergo-trainer. For standing position in the gymnasium the kinematics analysis indicated a 24 degrees mean lateral bicycle oscillation compared with 0 degrees on the ergo trainer.

CONCLUSION

The results of this study indicate that POpeak, Fo, and time to obtain POpeak were different between laboratory and actual cycling conditions. To obtain a valid estimation of the maximal power output, it is necessary to perform sprint tests during actual cycling locomotion. Thus, in the laboratory, it is advisable to use a cycle ergometer that enables natural lateral oscillations.