nonalcoholic fatty liver disease (NAFLD) is characterized by excessive accumulation of fat in the liver without alcoholism. We conducted a systematic review and meta-analysis to elucidate the ...efficacy of aerobic exercise on metabolic indicators and physical performance of adult patients with NAFLD.
To conduct the systematic review and network meta-analysis, 2 researchers searched PubMed, EBSCO, and Web of science databases to identify randomized clinical trials of aerobic exercise interventions for adults with NAFLD published between inception and July 2022. We assessed the methodological quality of the included literature using the Cochrane Risk Assessment Scale and the PEDro Scale. Relevant data were extracted, variables were converted to the same units, and meta-analysis was performed using RevMan 5.4 software. We compared mean differences (MD) between experimental and control groups. For each outcome analyzed, we expressed data as MD with 95% CI to compare metabolic markers and exercise capacity between the experimental and control NAFLD patients.
Eleven randomized clinical trials with a total of 491 individuals with NAFLD were included in accordance with the criteria of this study. Types of aerobic exercise include moderate or high-intensity interval running, cycling, Nordic walking, equipment training, etc; Training duration 4 to 16 weeks, 30 to 60 minutes 3 or more times a week. Compared with the control group, aerobic exercise group had reduced weight of patients, (MD) 1.20 kg (95% CI: -1.38 to -1.01 kg, P < .00001). Seven studies confirmed that aerobic exercise significantly reduced triglycerides, (MD) 3.00 mg/dL (95% CI: -5.80 to -0.21 mg/dL, P = .04); increased high density lipoproteins (MD) 5.96 mg/dL (95% CI: 2.95 to 8.96 mg/dL, P = .0001) and reduced low-density lipoproteins (MD) 6.45 mg/dL (95% CI: -8.53 to -4.37 mg/dL, P < .00001); the study also showed that aerobic exercise reduced the liver enzymes aspartate aminotransferase and alanine aminotransferase to varying degrees. Aerobic exercise can improve physical performance and increase peak oxygen consumption of (MD) 6.29 mL/Kg*minutes, (95% CI: 3.05-9.53mL/Kg*minutes, P = .0001).
Aerobic exercise significantly reduced weight and improved metabolic index and physical performance. Impacted by the limitations of various regimens, doses, duration, center settings, populations enrolled, the study had certain limitations. The randomized controlled trials with larger sample sizes, multiple centers, and high quality should be conducted to validate the above conclusion. Further studies will be required to focus on the total duration of the intervention, duration and frequency of sessions, and intensity that are optimal for the promotion of physical performance and metabolic capacity in this population.
Aging is associated with sarcopenia and functional decline, leading to frailty and disability. As a modifiable risk factor, nutrition may represent a target for preventing or postponing the onset of ...these geriatric conditions. Among nutrients, high-quality protein, leucine, vitamin D, and omega-3 polyunsaturated fatty acids (
-3 PUFA) are of particular interest for their demonstrated effects on skeletal muscle health. This narrative review aims to examine the recent observational and interventional evidence on the associations and the role of these nutrients in the muscle mass, strength, mobility, and physical function of free-living older adults, who are either healthy or at risk of frailty. Recent evidence supports a higher protein intake recommendation of 1.0⁻1.2 g/kg/day in healthy older adults; an evenly distributed mealtime protein intake or minimal protein per meal may be beneficial. In addition, vitamin D supplementation of 800⁻1000 IU, particularly when vitamin D status is low, and doses of ~3 g/day of
-3 PUFA may be favorable for physical function, muscle mass, and strength. Reviewed studies are highly heterogenous, yet the quantity, quality, and timing of intakes should be considered when designing intervention studies. Combined protein, leucine, vitamin D, and
-3 PUFA supplements may convey added benefits and may represent an intervention strategy in the prevention of sarcopenia and functional decline.
Respiratory/inspiratory muscle training (RMT/IMT) has been proposed to improve the endurance performance of athletes in normoxia. In recent years, due to the increased use of hypoxic training method ...among athletes, the RMT applicability has also been tested as a method to minimize adverse effects since hyperventilation may cause respiratory muscle fatigue during prolonged exercise in hypoxia. We performed a review in order to determine factors potentially affecting the change in endurance performance in hypoxia after RMT in healthy subjects. A comprehensive search was done in the electronic databases MEDLINE and Google Scholar including keywords: "RMT/IMT," and/or "endurance performance," and/or "altitude" and/or "hypoxia." Seven appropriate studies were found until April 2018. Analysis of the studies showed that two RMT methods were used in the protocols: respiratory muscle endurance (RME) (isocapnic hyperpnea: commonly 10-30', 3-5 d/week) in three of the seven studies, and respiratory muscle strength (RMS) (Powerbreathe device: commonly 2 × 30 reps at 50% MIP (maximal inspiratory pressure), 5-7 d/week) in the remaining four studies. The duration of the protocols ranged from 4 to 8 weeks, and it was found in synthesis that during exercise in hypoxia, RMT promoted (1) reduced respiratory muscle fatigue, (2) delayed respiratory muscle metaboreflex activation, (3) better maintenance of SaO
and blood flow to locomotor muscles. In general, no increases of maximal oxygen uptake (VO
) were described. Ventilatory function improvements (maximal inspiratory pressure) achieved by using RMT fostered the capacity to adapt to hypoxia and minimized the impact of respiratory stress during the acclimatization stage in comparison with placebo/sham. In conclusion, RMT was found to elicit general positive effects mainly on respiratory efficiency and breathing patterns, lower dyspneic perceptions and improved physical performance in conditions of hypoxia. Thus, this method is recommended to be used as a pre-exposure tool for strengthening respiratory muscles and minimizing the adverse effects caused by hypoxia related hyperventilation. Future studies will assess these effects in elite athletes.
With the rapid population aging, the challenge to provide care for disabled older adults is becoming bigger. This study aims to develop the Disability Index (DI) to assess disability to indicate care ...needs, and we evaluated the reliability and validity of the DI among older adults aged 65-105.
A total of 12 559 older adults (54.0% women; mean age = 84.3; SD = 11.2) from 22 provinces in China were investigated in 2017-2018. We developed the 21-item DI covering 4 subdomains, including Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), physical performance, and cognitive function. Cronbach's alpha was used to determine internal consistency. The convergent and divergent validity were assessed by Spearman rank order correlation coefficients and Pearson correlation coefficients. The known-group validity was assessed by Mann-Whitney U tests. The concurrent validity was assessed by the area under the receiver operating characteristic curve (AUC).
In the total sample, the internal consistency of the full DI and its subdomains were satisfactory with Cronbach's alpha ≥0.70; the convergent and divergent validity of the 4 subdomains were supported by all the alternative measures; the known-group validity of the full DI and its subdomains were supported by clear discriminative ability; and the concurrent validity of the full DI was supported with all the AUCs ≥0.70. The reliability and validity of the full DI and its subdomains were additionally supported by age subgroups and sex subgroups.
The DI is a reliable and valid instrument to assess disability status among older adults.
Purpose
The aim of the present meta-analysis was to quantify effects of resistance exercise (RE) on physical performance and function, body composition, health-related quality of life (HRQoL), and ...fatigue in patients with prostate cancer.
Methods
Trial data were obtained from the databases PubMed, MEDLINE, EMBASE, SCOPUS, and the Cochrane Library as of inception to 31st of December 2016. Thirty-two trials with 1199 patients were included. Results that were measured by using the same assessment method in five or more of the original studies were pooled in a meta-analysis.
Results
Pooled studies showed significant improvements of muscular strength in the upper and lower body (95% CI 2.52, 7.97 kg;
p
< 0.001 and 95% CI 10.51, 45.88 kg;
p
= 0.008, respectively) after RE. Furthermore, significant improvements were seen for body composition (body fat percentage 95% CI −0.79, −0.53 %;
p
< 0.001; lean body mass 95% CI 0.15, 1.84 %;
p
= 0.028; trunk fat mass 95% CI −0.73, −0.08 kg;
p
= 0.024). Additionally, the improvement of the 400-m walk time was significant (95% CI −21.55, −14.65 s;
p
< 0.001). Concerning fatigue and HRQoL, there were not sufficient data for analysis.
Conclusions
RE seems to be a promising approach in order to counteract loss of muscle mass, muscle strength, and physical performance in patients suffering from prostate cancer and its treatment-related side effects. RE should play part in interdisciplinary cancer rehabilitation and care of this patient group. Nevertheless, further research should investigate RE further to determine which protocols are the most pragmatic, yet yielding best patient outcomes.
Stroke-related sarcopenia: specific characteristics Scherbakov, Nadja; Sandek, Anja; Doehner, Wolfram
Journal of the American Medical Directors Association,
04/2015, Letnik:
16, Številka:
4
Journal Article
Recenzirano
Sarcopenia is characterized by muscle wasting and is primarily a disease of the elderly. A stroke-specific sarcopenia has been described recently. Stroke-related sarcopenia has a number of features ...that distinguish it from the age-related sarcopenia. The disability from stroke depends on the brain lesion leading to impairment of the efferent neuronal pathways. However, the alterations of structural and functional muscle capacity are secondary and depend rather on complex pathophysiological reactions including imbalanced efferent neurovegetative control, systemic and local metabolic imbalance, feeding difficulties, and inflammation. Muscle structural changes start to develop within hours after stroke, followed by rapid reduction of muscle mass. The pathophysiological mechanisms leading to the muscle mass decline are still not understood in details. This review provides insights into the specific features of the stroke-related sarcopenia. Recent research achievements in this area and clinical implications will be discussed.
The aim of this investigation was to determine whether, after Ramadan, pre-exercise caffeine intake can reduce any possible negative effects of this month on short-term maximal performances in young ...female handball players. A randomized study involved thirteen young female handball players. Participants performed a squat jump (SJ), Illinois agility test (AG), and 5 m run shuttles test (total (TD) and peak (PD) distances) at 08:00 AM and 06:00 PM on three different occasions: one week before Ramadan (Pre-R), the last week of Ramadan (R), and the week after Ramadan (Post-R). A placebo (Pla) or caffeine (Caff) (6 mg·kg
) was administered 60 min before exercise test sessions at two distinct times of day (08:00 AM and 06:00 PM) during the two periods: Pre and Post-R. The PSQI and dietary intake were assessed during all testing periods. The results revealed that Pre-R, (SJ, AG, TD, and PD) test performances were greater in the evening (PM) than in the morning (AM) (all
< 0.001). However, compared with Pre-R, PM performances declined significantly during R (all
< 0.001) and Post-R (
< 0.05,
< 0.01,
< 0.01 and
< 0.001, respectively). In addition, Pre-R, AM Caff produced moderate significant improvements compared with AM Pla, with small-to-no beneficial effects observed with PM Caff in SJ (4.8% vs. 1%), AG (1.8% vs. 0.8%), TD (2.8% vs. 0.3%), and PD (6% vs. 0.9%). Nevertheless, Caff produced moderate ergogenic effects during both AM and PM sessions during Post-R in SJ (4.4% vs. 2.4%), AG (1.7% vs. 1.5%), TD (2.9% vs. 1.3%), and PD (5.8% vs. 3%) with values approaching those of Pre-R Pla within the same time of day (
> 0.05,
> 0.05,
< 0.05, and
< 0.05, respectively). In summary, pre-exercise Caff intake with a dose equivalent to 6 mg·kg
reduced the negative effects of Ramadan fasting in several aspects of short-term maximal performances in young female handball players at both times of the day.
Abstract
Background
Previous studies examining unidirectional relationships between social isolation and physical functioning among older adults may be biased due to reverse causality. This study ...leveraged data from a US national sample of older adults and a novel estimation method to identify bidirectional associations between these 2 phenomena and their associated temporal dynamics.
Methods
The analyses were based on 9 waves of panel data from a sample of adults aged 65 and older from the US National Health and Aging Trends Study (n = 12 427 individuals) and a cross-lagged panel model. Social isolation was measured using the Social Isolation Index (SII) and physical functioning through the Short Physical Performance Battery (SPPB).
Results
One SD increase in the SPPB was associated with a −0.013 SD decrease (95% confidence interval CI: −0.023 to −0.004) in the SII a year later, whereas 1 SD increase in the SII was associated with a larger −0.058 SD decrease (95% CI: −0.069 to −0.046) in the SPPB a year later. The SII→SPPB effect lasted for approximately 5 years, whereas the SPPB→SII lasted for approximately 3 years.
Conclusions
This study confirmed the existence of statistically significant bidirectional associations between social isolation and physical functioning among older adults in the United States, net of reverse causation. Because the effect of social isolation dominates, the findings indicate that public health strategies to promote successful aging should prioritize interventions that enrich older adults’ social networks. Furthermore, the effect time horizons yielded by the model point to the optimal timing for the re-delivery of interventions.
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