Level and limitations of physical activity in patients with excess body weight or diabetes.

Physical activity (PA) is recommended to prevent or treat many diseases, but various factors may limit it. We analyse the level of PA and the barriers to undertaking it. Patients aged 18-64 with diabetes or at least overweight completed the following questionnaires: International Physical Activity Questionnaire (IPAQ) and Accompanying Survey (AS). For statistical analysis, non-parametric Mann-Whitney U, χ2-Pearson, correspondence analysis and meta-analysis (OR with ±95% CI) were used, and α=0.05 was assumed. Of 191 sets of questionnaires were analysed (67% from women). The median (MD) age for the group was 50.5 years, MD for metabolic equivalents (METs): 2079 (MET-min/week); 16.23% of subjects scored insufficient, 46.07% sufficient and 37.7% high PA according to the IPAQ scale. A relationship between the IPAQ and PA level results from the AS was confirmed (χ2; p=0.00047). The most common reasons indicated for not taking up PA were lack of time due to professional work (49%) and additional duties (32%) as well as fatigue from daily duties (44%). Participants <45 years were more likely to indicate additional duties (p=0.013), participants >45 years illnesses (p=0.04) and people with BMI (body mass index) ≥30 kg/m2, 'fatigue from daily duties' (p=0.019) as an obstacle to undertaking PA. 'Lack of suitable conditions to undertake PA' was indicated more often by patients with primary education (p<0.01), diabetes (p=0.037), after myocardial infarction (p=0.039) and those under psychiatric treatment (p=0.039). Women more often declared a lack of motivation (p=0.018). Residents of big cities and those with BMI ≥30 were more likely to assess their PA as 'insufficient' (p=0.0260 and p=0.0081, respectively). The overwhelming number of respondents who were in the age of professional activity had a sufficient level of PA. The most common barriers to undertaking PA were lack of time and fatigue, related to both work and non-work activities, but specific barriers were also found for women and patients with various diseases.

Is It Possible to Train the Endothelium?-A Narrative Literature Review.

This review provides an overview of current knowledge regarding the adaptive effects of physical training on the endothelium. The endothelium plays a crucial role in maintaining the health of vessel walls and regulating vascular tone, structure, and homeostasis. Regular exercise, known for its promotion of cardiovascular health, can enhance endothelial function through various mechanisms. The specific health benefits derived from exercise are contingent upon the type and intensity of physical training. The review examines current clinical evidence supporting exercise's protective effects on the vascular endothelium and identifies potential therapeutic targets for endothelial dysfunction. There is an urgent need to develop preventive strategies and gain a deeper understanding of the distinct impacts of exercise on the endothelium.

The Impact of the First Wave of the COVID-19 Pandemic on University Staff Dietary Behaviours, Sleeping Patterns, and Well-Being: An International Comparison Study.

This study assessed the impact of the first wave of the COVID-19 pandemic on well-being by measuring the changes to food security, dietary behaviour, and sleeping patterns of university staff in England, Poland, Saudi Arabia, and China. Using a cross-sectional study design, participants in four universities in the respective countries were surveyed between June and July 2020. The mean age of the 902 participants was 42 years old and 67% were female. The findings indicate a reduction in emotionally driven food behaviour [t (901.00) = -20.87, p < 0.001], food acquisition location [t (901.00) = -51.55, p < 0.001], skipping meals [t (901.00) = -24, p < 0.001], and consumption of canned fruit and vegetables [t (901.00) = -10.18, p < 0.001]. However, home cooking [t (901.00) = 36.61, p < 0.001] and the food shopping experience [t (901.00) = 4.53, p < 0.001] markedly increased during lockdown. The participants had higher levels of well-being during the pandemic and experienced a significant increase in sleeping hours (p < 0.001). Increased age and sleeping hours were positively associated with overall well-being. Conversely, emotionally driven food behaviour (i.e., buying and eating more food out of boredom/fear or anxiety) and skipping meals decreased the overall well-being. Lockdown had beneficial effects on dietary behaviours, sleeping patterns, and well-being, but there were variations between countries.

Physical Activity Modifies the Severity of COVID-19 in Hospitalized Patients-Observational Study.

BACKGROUND AND AIM: Physical activity (PA) can modulate the immune response, but its impact on infectious disease severity is unknown. We assess if the PA level impacts the severity of COVID-19. METHODS: Prospective, cohort study for adults hospitalized due to COVID-19, who filled out the International Physical Activity Questionnaire (IPAQ). Disease severity was expressed as death, transfer to intensive care unit (ICU), oxygen therapy (OxTh), hospitalization length, complications, C-reactive protein, and procalcitonin level. RESULTS: Out of 326 individuals, 131 (57; 43.51% women) were analyzed: age: median-70; range: 20-95; BMI: mean-27.18 kg/m²; and SD: ±4.77. During hospitalization: 117 (83.31%) individuals recovered, nine (6.87%) were transferred to ICU, five (3.82%) died, and 83 (63.36%) needed OxTh. The median for the hospital stay was 11 (range: 3-49) for discharged patients, and mean hospitalization length was 14 (SD: ±5.8312) for deaths and 14.22 days (SD: ±6.92) for ICU-transferred patients. The median for MET-min/week was 660 (range: 0-19,200). Sufficient or high PA was found in recovered patients but insufficient PA was observed in dead or ICU-transferred patients (p = 0.03). The individuals with poor PA had a higher risk of death (HR = 2.63; ±95%CI 0.58-11.93; p = 0.037). OxTh was used more often in the less active individuals (p = 0.03). The principal component analysis confirmed a relationship between insufficient PA and an unfavorable course of the disease. CONCLUSION: A higher level of PA is associated with a milder course of COVID-19.

Validity and reliability of the Polish version of the Michigan Neuropathy Screening Instrument.

BACKGROUND: Diabetic sensorimotor polyneuropathy is an important risk factor for foot ulceration and amputation. Thus, patients with diabetes should be screened for this disorder according to local guidelines. An obstacle to the diagnosis of this disease may be the lack of unified diagnostic criteria due to the lack of properly validated scales used for assessment. AIM: To validate both sections (A and B) of the Michigan Neuropathy Screening Instrument (MNSI) in Polish (PL) patients with diabetes. METHODS: A cross-sectional study using a test (A1, B1) and re-test (A2, B2) formula was performed in 80 patients with diabetes. The gold standard used for neuropathy detection was a nerve conduction study (NCS) which was performed in all participants. Reliability of the MNSI-PL was assessed using the Cronbach's alpha, Kuder-Richardson formula 20 (KR-20), split-half reliability, the Gottman split-half tests, and correlation between first and second half was accessed. Stability was assessed using an intraclass correlation coefficient (ICC). For external validation, we used simple linear correlation, binomial regression, and agreement between two different tools using a Bland-Altman plot analysis. RESULTS: The scale was internally consistent (Cronbach's alpha for the full scale: 0.81 for A and 0.87 for B). MNSI-PL scores in test/retest showed high stability (ICC = 0.73 for A and ICC = 0.97 for B). The statistically important correlations between MNSI-PL and NCS were found for B1, B2, and A1 (P < 0.005). The cut-off points of ≥ 3 for section A (sensitivity of 90%-100%; specificity of 33%-40%) and ≥ 2 for section B (sensitivity of 81%-84%; specificity of 60%-70%) were obtained during neuropathy detection. CONCLUSION: The MNSI-PL is a reliable and valid instrument in screening for diabetic neuropathy.

The effectiveness of rehabilitation of patients with injuries as part of the Social Insurance Institution's disability prevention.

BACKGROUND: Injuries are the cause of professional and social deactivation. The rehabilitation program provided under Social Security prevention pension enables earlier rehabilitation measures. OBJECTIVE: The study's aim was to determine the efficiency of the rehabilitation as a part of Social Security prevention pension in the group of patients after limb injuries depending on the time when rehabilitation was undertaken. METHODS: The study was a retrospective data analysis, based on medical histories of 93 patients after injuries, rehabilitated as part of Social Security prevention pension from January 2016 until July 2017. The effects of rehabilitation were assessed in 2 groups: early (up to 6 months from the injury) and late rehabilitation (over 6 months). Medical effects are based on measurements of the motion range in extremities' joints, functional test results and final evaluation of the rehabilitation. RESULTS: For both groups, the motion range of most joints improved. Improvement among the group of early rehabilitated patients concerned everyday activities (p = 0.035), the results of medical rehabilitation (p = 0.046) and also the results of the functional tests. CONCLUSION: Comprehensive rehabilitation of patients after the injuries in Social Security prevention pension leads to better medical effects. The results are better for earlier rehabilitated patients.

COVID-19 Vaccine Acceptance in Pregnant and Lactating Women and Mothers of Young Children in Poland.

Purpose: The World Health Organization indicated vaccine hesitancy as one of the top 10 threats to global health. The success of a vaccine depends not only on its efficacy but also on its acceptance. Our study aims to define COVID-19 vaccine acceptance in a sample of pregnant and lactating women in Poland. Since mothers are often key decision-makers for whether their children will receive vaccination, it is vital to measure vaccine confidence among this group. Patients and Methods: An anonymous online survey was distributed to assess the level of acceptance of COVID-19 vaccination among pregnant and lactating women for themselves and their children in Poland. Results: The trust of pregnant and breastfeeding women and women who have offspring in government, in healthcare professionals, in scientific authorities, and sound scientific data is strongly associated with vaccine acceptance and may influence an individual's decision to perceive recommended actions as beneficial to the society as a whole. Conclusion: Acceptance and confidence in receiving the COVID-19 vaccination among pregnant and lactating women and mothers with young children is strongly associated with feelings of trust in government, health professionals, scientific authorities, and sound scientific data. The dissemination of professional and reliable information regarding the safety and efficacy of COVID-19 vaccine uptake by qualified health care personnel can significantly increase the level of trust and public awareness regarding the safety and efficacy of COVID-19 vaccine uptake in pregnancy, while breastfeeding, and mothers with young children.

The impact of lockdown caused by the COVID-19 pandemic on glycemic control in patients with diabetes.

PURPOSE: The aim the study was to assess the impact of the lockdown due to COVID-19 on diabetes control. METHODS: The HbA1c value from a pre-lockdown visit (V1) from patients with diabetes was compared to the lockdown visit one (V2) after 3-5 months of its duration. Additional information on how the HbA1c changed and which variables can modify HbA1c during lockdown was also studied. RESULTS: Records from 65 patients (type 2 diabetes -96,9%) were eligible and revealed that: HbA1c was at the target in 60% of the patients at V2 compared to 40% at V1; HbA1c decreased and normalized in 19, but worsened in 4 participants during the lockdown. No impact on HbA1c of: sex, age, diabetes duration, therapy type and modification before the pandemic, abandonment of the treatment, previous problems with glycemic control, or change in body weight and physical activity during the lockdown, was found. The previous macrovascular complications were the only variable that affected the increase in HbA1c (p = 0.0072), OR = 5.33. CONCLUSIONS: The COVID-19 pandemic has not revealed worsened glycemic control in patients with type 2 diabetes, in general. The patients with macrovascular complications turned out to be at risk of the harmful impact of the restrictions on the HbA1c.

Factors affecting rehabilitation of infants with Central Coordination Disorders during a three-month-long observation.

BACKGROUND: Central coordination disorders (CCD) encompass various abnormalities observed in infants but early therapy may have an impact on their condition. The aim was to seek factors that may affect the early results of therapy of infants with CCD. METHODS: We analyzed the outcomes of a three-month period of rehabilitation of infants living with CCD. Children were treated at Non-public Specialist Healthcare Institution Medi-Reh in Kalisz in the period from 1 Jan 2014 to 31 Nov 2019. In our retrospective study results of three-month therapy of infants, aged 1 to 6 months, with CCD were analysed regards to the effectiveness and the potential impact of different factors. Therapy and assessment of children were conducted with the use of the Vojta method, which was performed during the first visit (WW) and the follow-up visit (after 3 months- 1WK). The analysis of the influence of various factors on the effect of therapy included: mother's age at the time of delivery, duration of breastfeeding, child APGAR, gestational age in which the child was born, sex of the child, birth weight, age of the child at WW, type of delivery, craniosacral therapy as an additive treatment. RESULTS: Based on the examination results from 66 medical records it was demonstrated that after active period of the therapy, improvement was observed in 54 (81.81%) (p=0.48) children (condition during WW versus 1WK among the group). The sole factor impacting improvement after 3 months was the age of the child at WW, when the child started therapy. This factor significantly (p=0.002) increased the chance of achieving improvement - by 3.2 times (OR= 3,2; CI= 95). No statistically significant differences were shown for the other studied factors. CONCLUSIONS: Prompt implementation of rehabilitation in children with CCD provides a better chance of improving their motor function. The rehabilitation should be started as soon as possible after the diagnosis is constituted.

Assessment of the level of anxiety and pain in women who do and do not attend childbirth classes during the SARS-CoV-2 pandemic.

INTRODUCTION: Participation in childbirth classes is aimed at learning to cope with the anxiety that accompanies a woman during her pregnancy and childbirth. The aim of the study was to answer the question whether the lack of access to childbirth classes affected anxiety and perinatal pain in pregnant women who gave birth during the pandemic period. MATERIALS AND METHODS: This cross-sectional survey-based study involved women who were pregnant during the lockdown period. The respondents were asked to fill in the following questionnaires: a personal questionnaire, the Polish version of the Delivery Fear Scale and the Numeric Rating Scale for the assessment of average and maximum pain experienced during the labour. The survey was completed within 24-72 hours after the birth of the child. The obtained questionnaires were divided into 2 groups based on the information concerning attending or not attending childbirth classes (divided into subgroups): group A - patients participated in childbirth classes, and group B - patients did not participate in childbirth classes. RESULTS: Groups were homogeneous in terms of age, weight, height, body mass index and week of gestation. Perception of anxiety did not differ between groups. There was a correlation between particular formulation of the Delivery Fear Scale and "week of gestation" variable. In the group of women who gave birth naturally without anesthesia, there were no significant differences between groups in terms of mean and maximum pain during labour. CONCLUSION: The level of anxiety and pain associated with childbirth is not modulated by childbirth classes during the pandemic period. There is s a correlation between particular formulation of the Delivery Fear Scale and "week of gestation" variable. In the group of women who gave birth naturally without anesthesia, there are no significant differences between groups in terms of mean and maximum pain during labour.

The Use of Medical and Non-Medical Services by Older Inpatients from Emergency vs. Chronic Departments, during the SARS-CoV-2 Pandemic in Poland.

The COVID-19 pandemic has forced numerous changes in medical care. The monitoring of current needs and problems among the elderly in health care facilities seems to be essential. This study aims to assess the difference in terms of the use of medical and non-medical services before planned or emergency hospitalisation by the older population during the strict lockdown period due to the SARS-CoV-2 pandemic in Poland. The study used the FIMA (Fragebogen zur Inanspruchnahme medizinischer und nicht-medizinischer Versorgungsleistungen im Alter) questionnaire. Patients admitted on a planned basis (n = 61) were on average 4 years younger, self-administered the questionnaire more frequently and used the services of different types of therapists. Patients admitted on an emergency basis (n = 60) were more likely to visit general practitioners and other specialists and used the carer's allowance benefits. In the case of the elderly, emergency hospitalisation during the pandemic is more frequently preceded by seeking outpatient care in specialists in various fields, covered by insurance. The chronically ill use the services of various therapists while awaiting hospitalisation, usually not covered by health insurance. For both groups, the age > 73 years is critical for the use of assisting means and completing the self-administered questionnaire, which can be used in planning the health care in these patients.

Patients with Diabetes Complicated by Peripheral Artery Disease: the Current State of Knowledge on Physiotherapy Interventions.

Diabetes mellitus (DM) is one of the major public health problems that account for morbidity, mortality, and disability worldwide. The presence of DM increases the risk of peripheral artery disease (PAD), as well as accelerates its course, making these patients more susceptible to ischemic events and impaired functional status. Unfortunately, alternative treatments for vascular complications in diabetes are poorly researched. Physiotherapy (kinesitherapy combined with different physical therapy agents) in individuals with DM and coexisting PAD may offer an important complementary therapy alternative. Early therapeutic measures can significantly improve patient outcomes, reduce cardiovascular risk, and improve daily life quality. The article provides an update on the current state of knowledge on physiotherapy interventions in the course of DM in patients with coexisting PAD.

The Use of Medical and Non-Medical Services by the Elderly during the SARS-CoV-2 Pandemic Differs between General and Specialist Practice: A One-Center Study in Poland.

In Poland, there is a lack of documented data on the use of medical and non-medical services by the elderly during the SARS-CoV-2 pandemic. The FIMA questionnaire assesses the use of medical and non-medical services by the elderly. The authors compared the demand for these services during the ongoing pandemic with similar months in 2017. It was confirmed that in the group of 61 surveyed elderly people, the number of individuals who had a medical visit decreased significantly in the three-month period. In the analyzed pandemic period, patients had significantly fewer visits to their general practitioner only. The pandemic had no significant impact on the use of other medical and non-medical services analyzed by FIMA. The limitations may include the small number of respondents, the relatively short period from the beginning of the pandemic covered by the survey, and the nature of the studied patients' diseases. Further observation of elderly patients' access to the abovementioned services can improve the efforts of governments and caregivers in this field, which is of particular importance in the group of chronically ill elderly patients.

Abdominal muscles activity during abdominal bracing and posterior pelvic tilt in women after natural birth and after caesarean delivery.

PURPOSE: Exercises after pregnancy can reduce the severity and risk of postnatal locomotor system disorders and muscular dysfunctions. The aim of the study was to evaluate electromyographic activity of abdominal muscles in women who gave birth naturally and via a caesarean section, and to compare it to a group of women who have never given birth. METHODS: 27 women were included into the study after completing the personal questionnaire and functional examination. The surface electromyography during abdominal bracing and posterior pelvic tilt was used to test rectus abdominis muscles and internus oblique/ transversus abdominis muscles bilaterally. After normalization test, patients were asked to perform abdominal bracing and posterior pelvic tilt exercises. RESULTS: Activity of rectus abdominis muscle is higher in posterior pelvic tilt compared to abdominal bracing. It should be noted that the internus oblique/transversus abdominis muscle activity in both exercises is similar. CONCLUSIONS: In women after natural birth and after a cesarean section who experienced no locomotor system symptoms, no statistically significant differences in abdominal muscle activity in both exercises were observed. In each group being studied, posterior pelvic tilt activated rectus abdominis muscles to a greater extent than just bracing.