Home-Based Indoor Physical Activity Programs for Community-Dwelling Older Adults: A Systematic Review.

CONTEXT: Home-based exercise programs are a good strategy to promote benefits to health for people who cannot visit gyms, clinics, or have limited time for physical activity outside. OBJECTIVE: To synthesize the effect of home-based indoor physical activity on psychosocial outcomes and mobility in community-dwelling older adults. DATA SOURCES: A comprehensive search was conducted in the MEDLINE, PubMed, Embase, SPORTDiscus, Cochrane Library, Scopus, and Google Scholar databases. STUDY SELECTION: A total of 11 studies (13 publications) were included involving a total of 1004 older adults. STUDY DESIGN: A systematic review of randomized controlled trials was conducted using the aforementioned 7 databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. LEVEL OF EVIDENCE: Level 2. DATA EXTRACTION: Two authors independently selected studies, extracted data, and determined the risk of bias and evidence level using the Grading quality of evidence and strength of recommendations (GRADE) guidelines. We conducted a synthesis without meta-analysis (SWiM) to assess the outcome. RESULTS: There is moderately certain evidence that home-based exercise programs reduced the fear of falling. Psychosocial (mental health and quality of life) and mobility outcomes may improve after participating in the intervention inside the home. CONCLUSION: The review found very low to certain evidence that home-based exercises programs improved psychosocial outcomes (mental health and quality of life) and walking speed (mobility). Moderately certain evidence suggests that home-based exercises improved fear of falling. PROTOCOL REGISTER NUMBER: CRD42020182008.

Standard hypothyroid treatment did not restore proper metabolic response to carbohydrate.

PURPOSE: Hypothyroidism is associated with a lower metabolic rate, impaired glucose tolerance, and increased responsiveness of sympathetic nervous system to glucose ingestion. The Levothyroxine (LT4) monotherapy is the standard treatment for hypothyroidism; however to what extent this treatment restores the patients' metabolism has not been verified. The aim of this study was to test the hypothesis that standard LT4 therapy may not restore proper metabolic response to carbohydrate ingestion. METHODS: Energy expenditure, glucose tolerance, and catecholamine response to glucose ingestion were compared in 18 subjects with pharmacologically compensated hypothyroidism (PCH) and controls, at baseline and during oral glucose tolerance test conditions. RESULTS: Metabolic rate was significantly lower in PCH (P < 0.0001). Glucose tolerance was decreased in this group with no differences in insulin resistance indicators between both groups. Adrenergic activity (P < 0.05) as well as adrenergic reaction to glucose ingestion (P < 0.001) were stronger in PCH. CONCLUSIONS: Standard treatment for hypothyroidism does not restore the normal metabolic reaction to carbohydrate which is observed in healthy people.