Background This study investigated health‐related fitness in adolescents with intellectual disabilities and analysed the various performances in physical fitness tests according to degrees of ...obesity.
Materials and Methods Eighty‐seven French intellectual disabilities adolescents (14.24 ± 1.48 years) performed the EUROFIT physical fitness test battery. Height, weight and waist circumference were assessed, and BMI and waist‐to‐height ratio were calculated. ‘Bio‐impedancemetry’ evaluated body fat (BF) percentage.
Results Ninety‐four per cent of the adolescents completed the aerobic running test, 52% of which had low VO2max. Thirty‐seven per cent were obese (%BF), and 32% had excess visceral adipose tissue. Adolescents with the lowest cardiorespiratory fitness had the highest BF percentages (P < 0.001).
Conclusions Intellectual disabilities adolescents showed low physical fitness and high prevalence of obesity. Both could further worsen social participation and health status.
Aging and increased vulnerability define the clinical condition of frailty. However, while the cervical function is recognized as a determinant of balance and walking performance, no study ...simultaneously physical ability, cervical function, balance, and plantar pressure distribution in walking in nursing house population. Thus, the present study aimed to compare these parameters between Frail and Pre-Frail aged people. Thirty-one (12 men and 19 women) institutionalized participants (age: 89.45 ± 5.27 years, weight: 61.54 ± 9.99 kg, height: 160.34 ± 7.93 cm) were recruited and divided into Pre-Frail and Frail groups according to SPPB (Short Physical Performance Battery) score (Frail <6, Pre-Frail ≥6). Participants performed the Timed Up and Go Test (TUGT) and a static balance evaluation. The cervical range of motion (COM), knee extensor strength, and walking plantar pressure distribution have been measured. The Pre-Frail group showed a higher gait speed (ES = 0.78,
≤ 0.001) and a better TUGT, as well as higher knee extensor strength (ES = 0.4,
= 0.04). Furthermore, the Pre-Frail group presented a center of pressure (COP) displacement velocity on the sagittal axis (ES = 0.43,
= 0.02) and a more COP projection on this axis (ES = 0.43,
= 0.02). No significant difference has been observed between the two groups concerning the total contact time and most of the plantar pressure parameters except for the rear foot relative contact time which was lower in the Pre-Frail group. The Pre-Frail group also showed better cervical tilt mobility (ES = 0.35,
= 0.04). This study highlights the influence of some new parameters on frailty in older people, such as cervical mobility and plantar pressure distribution in walking.
À ce jour, les programmes d’activité physique (AP) visant les personnes atteintes de surpoids et d’obésité s’organisent autour des recommandations érigées pour la population générale. Toutefois, ces ...personnes présentent des caractéristiques particulières qui nécessitent un accompagnement adapté. Afin de pouvoir amorcer un travail de recommandation, l’objectif de cet article était de répertorier les critères utilisés pour décrire et étudier les programmes d’AP à destination des personnes atteintes de surpoids et d’obésité et les suivis post-programmes. Une revue systématique des méta-analyses et revues systématiques portant sur la prise en charge du surpoids et de l’obésité adulte a permis, notamment, de mettre en évidence que peu d’éléments descriptifs des programmes sont rapportés de manière systématique, et que les programmes sont rarement suffisamment détaillés pour pouvoir calculer une dose d’AP ou permettre leur comparaison. Ces convergences, disparités ou manques dans la description des programmes d’AP, ont permis d’engager une réflexion sur l’intérêt des différents critères ainsi que sur l’intérêt de leur systématisation dans les dispositifs de prise en charge de la gestion du poids incluant l’AP, pour ce que nous espérons être une première étape vers l’élaboration de recommandations en matière de prise en charge du surpoids et de l’obésité par l’AP.
Les nouveautés
Objectif : répertorier les critères de description des programmes d’AP dans la prise en charge du surpoids et de l’obésité.
Critères à systématiser : calcul dose d’AP, individualisation programme.
Critères à développer : taux d’abandon comme indicateur d’adaptation du programme, stratégie de gestion de la fatigue.
Purpose
Lack of physical activity (PA), weight gain, and overweight have been associated with increased risk of recurrence and mortality after breast cancer diagnosis. We evaluated the feasibility of ...implementing an individualized exercise program and nutritional counseling during adjuvant treatment of localized invasive breast cancer.
Methods
Sixty-one patients eligible for adjuvant chemotherapy were randomized 2:1 to receive a 6-month program of weekly aerobic exercises associated with nutritional counseling (
n
= 41) or usual care with nutritional counseling (
n
= 20, one withdrawal). The primary endpoints were the proportion of patients compliant with two weekly supervised sessions and their overall adherence (i.e., proportion of supervised and unsupervised sessions completed versus planned sessions).
Results
Ten percent of patients in the intervention group were compliant with the two weekly supervised sessions for 6 months, but the overall median adherence rate was 85% of supervised and non-supervised sessions completed. Non-adherence was mainly due to intrinsic reasons (medical, organizational, psychological barriers). Adherence was positively associated with education and baseline PA level and inversely associated with baseline weight and tumor grade. No statistically significant benefits were observed in the intervention group, even if overall PA level and body composition improved and anthropometrics were maintained over time (
p
< 0.05).
Conclusions
Overall, there was good adherence with the 6-month exercise program during adjuvant treatment for breast cancer, despite poor compliance to twice-weekly supervised sessions. This study highlights the need for flexible exercise modalities and innovative experimental design to reach patients who would most adhere and benefit from intervention.
Trial registration:
ClinicalTrials.gov
Identifier: NCT01331772. Registered 8 April 2011,
https://clinicaltrials.gov/ct2/show/NCT01331772?term=pasapas&rank=1
Background
In adolescent with intellectual disability, the management of obesity is a crucial issue, yet also quite complex because of their particular perception of themselves. This study ...investigated the relationship between self‐perception variables and morphological variables and their changes after a 9‐month Adapted Physical Activity (APA) programme.
Materials and Methods
Twenty‐three adolescents with intellectual disability responded to an adapted questionnaire, including the PSI‐VSF‐ID and a nine‐drawing body silhouette scale. Anthropometric and body composition indicators were measured before and after the APA programme.
Results
The main predictor of the adolescents' self‐perceptions was the inclination towards positive illusory bias before the intervention; obesity awareness ranked second. Morphological measurements did not contribute in the same way to self‐perceptions in the initial and final data.
Conclusions
This study confirms the interest of weight management programmes for adolescents with intellectual disability and points to the need to take positive illusory bias more fully into account in the study of self‐perception.
We conducted preliminary studies testing the relevance of a new construct for understanding women's uninvolvement in regular physical activity: negative self-perception due to past PA experiences ...(NSPPPAE). In study 1, we tested the clarity of a three-item scale and computed principal component analysis, standardized Cronbach's alpha coefficients, and test-retest reliability using Pearson's correlation coefficient. In study 2, we performed principal component analysis, Pearson's correlation tests, and multiple regression analysis to determine (1) NSPPPAE's association with variables related to PA involvement and (2) NSPPPAE's power to predict time spent in vigorous or moderate recreational activity. The scale showed satisfactory internal consistency and good test-retest reliability. NSPPPAE was positively associated with time barrier (r = .31), tiredness barrier (r = .52), age (r = .15), and BMI (r = .28), and negatively associated with time in recreational activity (r = −.36). It significantly predicted (β = −.20, p = .003) time in recreational activity. This construct provides deeper insight into women's uninvolvement in regular PA.
In breast cancer patients, a lack of physical activity (PA) is 1 causative factor of weight gain during adjuvant treatment. It may increase the risk of treatment adverse effects, comorbidities, and ...deleterious long-term outcomes.
We aimed to describe the evolution of PA level and sedentary behavior in breast cancer patients between diagnosis and adjuvant chemotherapy onset following surgery and identify predictive factors associated with these changes early after breast cancer diagnosis.
Baseline data of 60 patients enrolled in a pilot randomized controlled trial of PA are presented. PA levels were estimated at adjuvant chemotherapy onset after surgery and retrospectively for the period at diagnosis. Height, weight, waist circumference, and bioelectrical impedance were measured at chemotherapy onset. Linear regression analysis evaluated factors associated with relative changes of PA level and sedentary behavior.
Moderate PA decreased and sedentary behavior increased between diagnosis and chemotherapy onset. A grade III breast cancer was associated with a greater decrease in PA level. Conversely, keeping a professional occupation and adherence to nutritional guidelines were associated with maintained PA level. The majority (88%) of patients had excessive adiposity at chemotherapy onset.
There was a significant deterioration of PA level between diagnosis and chemotherapy onset, and deleterious adiposity was present in most patients.
This study further emphasizes the need to motivate breast cancer patients toward engaging in a healthy lifestyle early after diagnosis and adhering to PA programs, which should be included in their clinical management.
Purpose:
Exercise has been shown to improve physical and psychological conditions during cancer therapy, but mechanisms remain poorly understood. The purpose of the present study was to report the ...results of cancer-related biomarkers and metabolomics outcomes from the PASAPAS feasibility study.
Methods:
In the PASAPAS randomized controlled trial, 61 women beginning adjuvant chemotherapy for localized breast cancer were randomized in a 6-month program of weekly aerobic exercises associated with nutritional counseling versus usual care with nutritional counseling. In the present analysis of 58 women for whom blood samples were available, first, circulating levels of biomarkers (ie, insulin, insulin-like growth factor 1, estradiol, adiponectin, leptin, interleukin-6, and tumor necrosis factor α) were measured at baseline and 6-month follow-up. Changes in biomarkers were compared between exercisers (n = 40) and controls (n = 18) using mixed-effect models. Second, serum metabolites were studied using an untargeted 1H nuclear magnetic resonance spectroscopy, and orthogonal partial least squares analyses were performed to discriminate exercisers and controls at baseline and at 6 months.
Results:
Over the 6-month intervention, no statistically significant differences were observed between exercisers and controls regarding changes in biomarkers and metabolomic profiles.
Conclusion:
The present analysis of the PASAPAS feasibility trial did not reveal any improvement in circulating biomarkers nor identified metabolic signatures in exercisers versus controls during adjuvant breast cancer treatment. Larger studies preferably in women with poor physical activity level to avoid ceiling effect, testing different doses and types of exercise on additional biological pathways, could allow to clarify the mechanisms mediating beneficial effects of physical exercise during cancer treatment.
Trial registration:
ClinicalTrials.gov Identifier: NCT01331772. Registered 8 April 2011, https://clinicaltrials.gov/ct2/show/NCT01331772?term=pasapas&rank=1
Opinion/feedback Among side effects, fatigue is the most common symptoms described by patients in a wide range of chronic diseases. Described as “being drained physically, but also mentally and ...emotionally,” often seen as the most distressing symptom, fatigue interferes with daily life by impairing quality of life, functional capacity, self-perception and social participation; it is potentially debilitating and it is associated with significant morbidity. Yet it remains relatively unknown, me-considered mis-assessed and mis-treated, partly due to the still limited understanding of its pathophysiology, its complex assessment, the lack of effective treatments (no medicine against fatigue apart specific pathological conditions) and of training to its management. The optimal management of fatigue is a key issue in the course of care, helping to reduce the burden associated with the disease and treatments. We will review the scientific evidence showing that PA is one of the best ways to handle the fatigue and fight against PA rupture, which is generally following the diagnosis, without compromising ongoing treatments. However, fatigue is a major obstacle to adherence to a regular PA. Systematic rest is an aggravating factor of fatigue. This is why only well-designed and conducted PA programs will help a person to start intelligently activity again (i.e., programs involving evaluation, programming, individualization in their design, and adapted support and monitoring in their implementation, all framed by a qualified professional). We will develop latest recommendations for the management of fatigue by PA and innovative indications for optimal programs.
To date, physical activity (PA) programs for overweight and obese people are built around recommendations established for the general population. However, these people have special characteristics ...that require adapted coaching. In order to begin this work of recommendations, the objective of this article was to list the criteria usually used to describe and study PA programs for overweight and obese people and its associated postprogram follow-up. A systematic review of both meta-analyses and systematic reviews related to PA programs in the management of overweight and obesity has highlighted that few descriptive elements of programs are systematically reported, and that PA programs are rarely sufficiently detailed to be able to calculate a PA dose or to compare the different programs. These convergences, disparities or gaps in the description of PA programs, led us to initiate a reflection on the interest of these criteria as well as on the interest of their systematization in weight management program design, including PA. We hope that will be a first step towards facilitating the development of recommendations for PA management of overweight and obesity. Novelty * Objective: to identify criteria used to describe PA programs in the management of overweight and obesity. * Criteria to systematize: data to calculate PA dose; description of program individualization strategy. * Criteria to develop: drop-out rate as an indicator of program adaptation; description of fatigue management strategy. Key words: physical activity, program, long-term, follow-up, overweight, obesity, systematic review. A ce jour, les programmes d'activite physique (AP) visant les personnes atteintes de surpoids et d'obesite s'organisent autour des recommandations erigees pour la population generale. Toutefois, ces personnes presentent des caracteristiques particulieres qui necessitent un accompagnement adapte. Afin de pouvoir amorcer un travail de recommandation, l'objectif de cet article etait de repertorier les criteres utilises pour decrire et etudier les programmes d'AP a destination des personnes atteintes de surpoids et d'obesite et les suivis post-programmes. Une revue systematique des meta-analyses et revues systematiques portant sur la prise en charge du surpoids et de l'obesite adulte a permis, notamment, de mettre en evidence que peu d'elements descriptifs des programmes sont rapportes de maniere systematique, et que les programmes sont rarement suffisamment detailles pour pouvoir calculer une dose d'AP ou permettre leur comparaison. Ces convergences, disparites ou manques dans la description des programmes d'AP, ont permis d'engager une reflexion sur l'interet des differents criteres ainsi que sur l'interet de leur systematisation dans les dispositifs de prise en charge de la gestion du poids incluant l'AP, pour ce que nous esperons etre une premiere etape vers l'elaboration de recommandations en matiere de prise en charge du surpoids et de l'obesite par l'AP. Les nouveautes * Objectif: repertorier les criteres de description des programmes d'AP dans la prise en charge du surpoids et de l'obesite. * Criteres a systematiser : calcul dose d'AP, individualisation programme. * Criteres a developper : taux d'abandon comme indicateur d'adaptation du programme, strategie de gestion de la fatigue. Mots-cles: activite physique, programme, long terme, suivi, surpoids, obesite, revue systematique.
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