The Effect of Aerobic Exercises on Arterial Stiffness in Older People: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVES: Aerobic exercise is a cost-effective intervention to improve arterial stiffness, but its effects on older people are unclear; this review aims to determine those effects. RESEARCH DESIGN AND METHODS: Five databases were searched for randomized controlled trials of aerobic exercises. Backward and forward citations and clinical trial registries were also reviewed. Data were extracted and synthesized. A random-effects model was used in a meta-analysis. The risk of bias and the certainty of the evidence were also assessed. The protocol of this review was registered (PROSPERO registration number: CRD42022349494). RESULTS: Eighteen studies (n = 775) were identified. Aerobic exercises included cycling, walking, swimming, standing core exercise, bench step exercise, aquarobic exercise, jogging, running, upper-limb cycling, and aquatic walking. Postintervention, improvements were seen in the pulse wave velocity (SMD9 = -0.89, 95% confidence interval (CI)-1.57 to -0.22), arterial velocity-pulse index (MD2 = -6.84, 95% CI -9.05 to -4.63), and arterial pressure-volume index (MD2 = -4.97, 95% CI -6.9 to -3.04), but not in the augmentation index, arterial compliance, or beta stiffness index. Exercise lasting >8 weeks but not 4-8 weeks significantly improved pulse wave velocity. Aerobic exercise had a beneficial effect on healthy older people but not on older people with disease. The overall risk of bias was high in 9 of the included studies, with some concerns in the remaining studies. The certainty of the evidence was very low. DISCUSSION AND IMPLICATIONS: Aerobic exercises, particularly those lasting >8 weeks, appear to be effective at improving pulse wave velocity in older people postintervention. Future trials with robust designs are needed.

Health status of aged women with or without the experience of practicing yoga.

BACKGROUND: Yoga is a popular training practice that enhances women's physical activity level and modifies the major risk factors contributing to noncommunicable diseases. This study aimed to compare general health and cardiovascular health, musculoskeletal health, psychological health, and health-related quality of life between aged women with and without long-term yoga practice. METHODS: Thirty-two female yoga practitioners (mean age 56 years) with ≥ 2 years experience in regular yoga practice and 32 age-matched women without yoga experience participated in the study. Between-group comparisons was performed to explore the differences in various health outcomes, including body build indices, exercise endurance, blood pressure, and heart rate variability; hamstring flexibility, upper-limb muscle strength, shoulder range of motion, and upper-limb function; and the symptoms of anxiety and depression, sleep quality, and fatigue. RESULTS: Our findings revealed that yoga practitioners demonstrated greater hamstring flexibility, shoulder ROM on the non-dominant side, and hand-grip strength; a higher heart rate variability parameter value (RMSSD); and shorter sleep latency than those who did not practice yoga. CONCLUSIONS: In view of the encouraging results of the long-term benefits of yoga practice, it warrants being promoted among aged women to enhance their physical and mental well-being.

Performance of physical, cardiovascular, and psychological functions in middle-aged women with and without breast cancer.

PURPOSE: To compare the physical performance, including upper-limb motor and cardiovascular functions, and psychological functions, including anxiety and depression, sleep, and fatigue, between women with and without breast cancer. METHODS: Thirty-two women with breast cancer and 32 healthy counterparts were recruited for the study. Upper-limb muscle strength, shoulder range of motion, and upper-limb function were assessed using a handheld dynamometer, a goniometer, and the short form of the Disabilities of Arm-Shoulder-Hand Questionnaire, respectively. Exercise endurance and cardiovascular functions were assessed using the 6-min walk test and blood pressure and heart rate variability, respectively. The Hospital Anxiety and Depression Scale, the Pittsburgh Sleep Quality Index, and the Fatigue Assessment Scale were used to assess the symptoms of anxiety and depression, sleep quality, and fatigue, respectively. RESULTS: Breast cancer participants' body-weight-adjusted upper-limb strength of both the affected and unaffected sides (0.11-0.14) was only 61.1-77.8% of those of the healthy participants (0.18). Their shoulder mobility of the affected side (flexion: 161.64°; abduction: 157.01°) were 94.2% (flexion) and 92.5% (abduction) of those of the healthy participants (flexion: 171.56°; abduction: 169.68°), respectively. Breast cancer participants had higher quickDASH mean score (19.53), HADS-A mean score (6.78), HADS-D mean score (4.72), global PSQI mean score (7.22) and FAS mean score (25.97) as well as shorter mean distance covered by 6 MWT (496.66 m) than those of the healthy participants. CONCLUSIONS: Rehabilitative interventions, such as mind-body interventions and exercise training, target physical fitness and promote the psychological health of women with breast cancer are necessary.

Effects of constraint induced movement therapy in patients with multiple sclerosis: A systematic review.

BACKGROUND: Multiple sclerosis (MS) is a chronic neurodegenerative disorder of the central nervous system (CNS) that commonly affects young and middle-aged adults. Neurodegeneration of the CNS affects its functions such as sensorimotor, autonomic and cognitive functions. Affectation of motor function can result in disability in performance of daily life activities. Thus, effective rehabilitation interventions are needed to help prevent disability in patients with MS. One of these interventions is the constraint induced movement therapy (CIMT). The CIMT is used to improve motor function in patients with stroke and other neurological conditions. Recently, its use in patients with MS is gaining ground. The aim of this study is to carry out a systematic review and meta-analysis to determine from the literature, the effects of CIMT on upper limb function in patients with MS. METHODS: PubMED, Embase, Web of Science (WoS), PEDro, and CENTRAL were searched until October 2022. Randomized controlled trials in patients with MS who were 18 years and above were included. Data on the characteristics of the study participants such as disease duration, type of MS, the mean scores of the outcomes of interest such as motor function and use of the arm in daily activities, and white matter integrity were extracted. Methodological quality and risks of bias of the included studies were assessed using PEDro scale and Cochrane risks of bias tool. The data was analysed using both narrative and quantitative syntheses. In the quantitative synthesis, random effect model meta-analysis of the mean and standard deviation of the scores on the outcomes of interest and the study sample size (for both the CIMT and the control group) post intervention was carried out. In addition, percentage of variation across the studies due to heterogeneity (I2) was considered significant when it is between 50% and 90% at p < 0.05. RESULTS: Two studies comprising of 4 published articles with good methodological quality were included in the study. The results showed that, CIMT is safe and improved white matter integrity, motor function, muscle strength, dexterity, real-world arm use and biomechanical parameters post intervention. However, although there was a trend towards better improvement in the CIMT group in all the outcomes, there was no statistically significant difference between groups in motor function (SMD=0.44, 95% CI=-0.20 to 1.07, p = 0.18) and quality of movement (SMD=0.96, -1.15 to 3.07, p = 0.37). CONCLUSION: CIMT can be used in patients with MS since it is safe as well as effective at improving functional outcomes. However, more studies are required to confirm its safety and effectiveness.

Contribution of sleep quality to fatigue following a stroke: a cross-sectional study.

BACKGROUND: The prevalence of fatigue and sleep disturbances is high in stroke populations. Sleep quality can be targeted by interventions to alleviate fatigue following a stroke. This study aimed to determine the prevalence of fatigue and poor sleep quality, and to quantify the contribution of sleep quality to fatigue following a stroke, in chronic (≥1 year) stroke survivors. METHODS: A cross-sectional design was adopted. A total of 112 stroke survivors (mean age ± standard deviation [year], 64.18 ± 5.77) at 6.08 ± 4.80 years post-stroke completed this study. All participants were assessed using the Fatigue Assessment Scale, the Pittsburgh Sleep Quality Index, the Visual Analogue Scale-Pain, the Fugl-Meyer Assessment of the upper and lower extremities, the 5-Time Sit-To-Stand Test, the Epworth Sleepiness Scale, the Frenchay Activities Index, the Life-Space Assessment, the Community Integration Measure, and the Multidimensional Scale of Perceived Social Support. Pearson and partial correlation coefficients were used to examine the correlation between fatigue and other variables. A multiple linear regression (the forced entry method) was performed to quantify the independent contribution of sleep quality to prediction of fatigue. RESULTS: Of the 112 participants, 52.7% reported experiencing fatigue and 64.3% reported poor sleep quality. Sleep quality could independently account for 5.9% of the variance in fatigue scores after a stroke. CONCLUSIONS: There is a high prevalence of fatigue and poor sleep quality in Chinese stroke survivors. Sleep quality is an independent predictor of fatigue in those living in the community who have survived a stroke for a year or longer.

A Systematic Review and Meta-Analysis: Biomechanical Evaluation of the Effectiveness of Strength and Conditioning Training Programs on Front Crawl Swimming Performance.

The objectives of this systematic review were to summarize and evaluate the effectiveness of strength and conditioning trainings on front crawl swimming, starts and turns performance with relevant biomechanical parameters. Four online databases including PudMed, ESCSOhost, Web of Science and SPORTDiscus were searched according to different combination of keywords. 954 articles were extracted from databases, and ultimately 15 articles were included in this study after removal of duplicate and articles screening according to inclusion and exclusion criteria. Meta-analyses were adopted when appropriate and Egger's regression symmetry was adopted to assess the publication bias and the results were presented with forest plots and funnel plots respectively. Fifteen articles studied the effects of strength and resistance, core, and plyometric trainings. The quality of the investigation was assessed by the checklist developed by Downs and Black. Most of the investigations found out that training programs were beneficial to front crawl sprinting swimming performance, stroke biomechanics, force, and muscle strength. First, strength and resistance trainings and core trainings were effective on sprinting performance enhancement. Second, resistance trainings were found to have positive effects on stroke rate. Plyometric trainings were beneficial to start performance, while there was no sufficient evidence for confirming the positive improvement on turn biomechanical, also overall swimming performance, after weeks of plyometric trainings. Strength and Conditioning trainings are suggested to implement in regular training regime regarding to the positive effects on swimming performance, including starts, turns and front crawl swim, and relevant biomechanical parameters, instead of swimming training only. Further research with higher quality is recommended to conduct and more investigations on the training effects to other stroke styles are also suggested.

Lesson Learned from Peer Volunteers in a Peer-Led Pain Management Program among Nursing Home Residents.

BACKGROUND: Chronic pain is common among older adults and is associated with adverse physical and psychological outcomes. Given the burden of pain and limited healthcare resources, devising innovative and cost-effective ways of managing chronic pain is of high priority. The aim of this paper is to explore the experiences and perceptions of peer volunteers (PVs) in a peer-led pain management program among nursing home residents in Hong Kong. METHODS: Forty-six PVs were recruited and trained to lead a pain management program (PAP). The PAP consisted of one 1 hour session per week for 12 weeks. It included 20 min of physical exercises performed under the supervision of PVs, followed by 30 min of pain management education, including information on pain situations, the impacts of pain, the use of drugs and non-drug strategies for pain management, demonstrations, and return demonstrations of various non-drug pain management techniques. Quantitative data were collected from questionnaires (demographics, pain situation, and pain knowledge) for all PVs. Qualitative data (PVs' experiences in leading the PAP, their perceived benefits, barriers encountered, and recommendations for improving the PAP) were collected at week 12 (upon completion of the PAP). Data were analyzed using the Statistical Package for Social Sciences and content analysis for qualitative data. RESULTS: A total of 46 PVs were recruited (34 females, 74%), with a mean ± SD age of 61.0 ± 5.1 years. Thirty-one of them reported having chronic pain. Before the training, their self-rated pain knowledge was 40.0 ± 20.5 (maximum 100 points) while their actual pain knowledge score was 86.1 ± 10.6 (maximum 100 points). The PVs reported an improvement in their knowledge and skills after leading PAPs. No PVs reported having received any negative comments about their role in leading the PAP but mentioned that they had received feedback on how to improve the program. CONCLUSIONS: This study provides further evidence that peer-led pain management programs are feasible and can lead to positive experiences for the PVs. Peer support models are coming into wide use because they show promise in helping patients to manage chronic conditions. Peer volunteers will become important resources in elderly care. The barriers that were identified may lead to improvements in the design and planning of future PAPs.

Pain and Pain Management Among University Students: Online Survey and Web-Based Education.

Pain is common among university students. Unrelieved pain has adverse impacts on their quality of life. In this study, a pain management Web site was developed to distribute an online survey and provide Web-based pain education to university students. Participants were recruited from eight universities in Hong Kong using snowball sampling. The online survey included 37 items examining pain situations, pain management strategies, knowledge about self-medication, and demographic data of the participants. A total of 387 students participated and over 90 percent of them reported pain in the past 6 months. Around one-third of participants did not take any action to manage their pain. Pharmacological method was the most common strategy for students to relieve pain (37.2 percent). The use of over-the-counter (OTC) drug for pain relief was high (n = 214). However, OTC drug knowledge score was significantly higher among health-related group than nonhealth-related group (p < 0.001). There were 188 students who also read the Web-based pain education and completed the evaluation on its usefulness. Nonhealth-related students reported significantly higher scores of self-perceived usefulness for the online education than the health-related students (p < 0.001). Findings suggested the need to consider the service users' background when developing online education program in the future.

Effects of a Peer-Led Pain Management Program for Nursing Home Residents with Chronic Pain: A Pilot Study.

OBJECTIVES : To examine the feasibility of a peer-led pain management program among nursing home residents. DESIGN : A quasi-experimental design. SETTING : Two nursing homes. SUBJECTS : Fifty nursing home residents. METHODS : The experimental group (n = 32) was given a 12-week group-based peer-led pain management program. There were two 1-hour sessions per week. Education in pain and demonstrations of nonpharmacological pain management strategies were provided. The research team and 12 trained peers led the sessions. The control group (n = 18) received one 1-hour session of pain management program each week over 12 weeks from the research team only. Outcome measures for the participants were collected at baseline (P1) and at week 12 (P2). Data from peer volunteers were collected prior to training (V1) and at week 12 (V2). T-tests were used to compare the differences in outcome measures collected at two time points. RESULTS : There was a significant reduction in pain intensity from 5.8 ± 2.6 (P1) to 3.4 ± 2.5 (P2) for the experimental group (p = 0.003) and from 6.3 ± 3.0 (P1) to 3.1 ± 2.4 (P2) for the control group (p = 0.001). Activities of daily living significantly improved for both the experimental group (p = 0.008) and the control group (p = 0.014). There was an enhancement in happiness level for the experimental group (p < 0.001), while the loneliness level dropped significantly for the experimental group (p < 0.001) and the control group (p = 0.031). The peer volunteers showed a significant increase in self-rated pain management knowledge (2.9 ± 2.6 to 8.1 ± 1.2, p < 0.001) and self-efficacy in volunteering (5.8 ± 2.9 to 8.3 ± 1.5, p = 0.032). CONCLUSION : The peer-led pain management program was feasible and has potential in relieving chronic pain and enhancing the physical and psychological health of nursing home residents.