Twelve-week intradialytic cycling exercise improves physical functional performance with gain in muscle strength and endurance: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of intradialytic cycling exercise on physical functional performance with gain in muscle strength and endurance in end-stage renal disease patients with haemodialysis. DESIGN: Randomized controlled trial, with repeated measurements at baseline and after 4, 8, and 12 weeks of intradialytic cycling exercise. SETTING: A 50-bed haemodialysis centre in a regional hospital in Taiwan. SUBJECTS: Seventy-six regular haemodialysis patients, recruited and equally and randomly assigned to exercise and control groups. INTERVENTION: The intradialytic cycling exercise was performed for 12 weeks and comprised warm-up, main, and cool-down exercise phases. A stationary cycling equipment was used, which involved aerobic and resistance modalities. The intensity was maintained at somewhat hard exertion. Each intradialytic cycling exercise was implemented for 30 minutes, starting at the second hour of treatment. MAIN MEASURE: Measured outcomes were 6-minute walk distance, time taken to complete 10 sit-to-stand-to-sit cycles and number of sit-to-stand-to-sit cycles in 60 seconds. RESULTS: Average (standard deviation) participant age was 55.47 (13.00) years. Therefore, the 6-minute walk distance was significantly different at weeks 8 (P = 0.01) and 12 (P < 0.001) in the exercise group compared with that in the control group at baseline. Notably, sit-to-stand-to-sit outcomes (P = 0.01) significantly influenced the 6-minute walk distance. Sit-to-stand-to-sit outcomes significantly improved in the exercise group (P < 0.05). CONCLUSION: Twelve-week intradialytic exercise for patients on haemodialysis can improve physical functional performance with gain muscle strength and endurance. This is a safe and effective method for improving health.

Exercises improve body composition, cardiovascular risk factors and bone mineral density for menopausal women: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Menopause has been considered as an aggravating factor for developing cardiovascular diseases and the metabolic syndromes for women. Exercise might be an effective intervention for reducing such threats. OBJECTIVE: The purpose of this study was to evaluate the exercise effects on body composition, cardiovascular risk factors, and bone mineral density of menopausal women. METHODS: Two reviewers did a complete search of five electronic database (Medline, PubMed, Cochrane Central Register of Controlled Trials, CINAHL, and the Chinese Electronic Periodical Service) records up to January 31, 2014. Randomized controlled trials (RCTs) that compared female menopausal participants with exercises, and those without exercise or with placebo were included. Risk of bias was classified based on the Cochrane Collaboration tool, the meta-analysis was conducted using Comprehensive Meta-Analysis Version 2.2. The study selection, data extraction, and validation were performed independently by the 2 reviewers. RESULTS: A total of 17 RCTs with 792 participants were included for meta-analysis. Among the eight RCTs (247 participants), a moderate effect size of exercise on body fat was found (SMD=-0.34, 95% CI: -0.60 to -0.08). In five RCTs (195 participants), a moderate effect size of exercise on waist circumference (SMD=-0.39, 95% CI: -0.68 to -0.09), in seven RCTs (162 participants), a moderate effect size on triglyceride level (SMD=-0.37, 95% CI: -0.62 to -0.11), and in five RCTs (311 participants), a moderate effect size on bone mineral density (SMD=0.38, 95% CI: 0.08-0.68). Subgroup analysis revealed a significant effect of aerobic exercise on body fat (SMD=-0.29, 95% CI: -0.53 to -0.06), and a short-term exercise on body fat (SMD=-0.50, 95% CI: -0.89 to -0.11) and on triglycerides (SMD=-0.42, 95% CI: -0.79 to -0.04). The trials included in this meta-analysis were small and some had methodologic limitations. CONCLUSIONS: This study provides evidences to clinical practice for menopause women that exercise, compared with nonexercise or placebo exerted significant benefits on body fat, waist circumference, triglyceride level, and lumbar spine bone mineral density. Particularly, aerobic exercise did help menopausal women improve their body fat. A short-term exercise intervention had a benefit on not only body fat but also triglyceride level. However, well-designed, well-executed RCTs, and a detailed long-term clinical research should be needed in the future.

Translation and Psychometric Testing of the Chinese Version of the Multidimensional Assessment of Interoceptive Awareness.

BACKGROUND: Mind-body interventions are used to alleviate physical and psychological symptoms. The multidimensional assessment of interoceptive awareness (MAIA), which is used to self-report the effects of mind-body interventions, is not currently available in Chinese. PURPOSE: This study aimed to translate the MAIA from English into Chinese (MAIA-C) and to examine the psychometric properties of the MAIA-C. METHODS: This was a methodological study. The MAIA was translated forward and backward systematically, and content validity was assessed by a panel of experts. A convenience sample of adult participants with mind-body practice was recruited from social clubs in Taiwan. The MAIA-C was administered to study participants. Internal consistency and test-retest reliability were tested using Cronbach's alpha and intraclass correlation coefficient. Construct validity was assessed in two ways: using confirmatory factor analysis and using the differences between the known groups to divide the sample into two groups of highly experienced and less experienced participants. RESULTS: The complete data for the 294 participants were analyzed. The eight-factor structure of the MAIA-C was confirmed. Cronbach's α was .91 overall and .46-.88 for the individual scales of the instrument. Intraclass correlation coefficient and composite reliability for the scales ranged from .60 to .85 and .55 to .87, respectively. The result of confirmatory factor analysis revealed a fair fit of the model to the data with a root mean square error of approximation of .076 and a comparative fit index of .95. Significant differences were found for the seven scales between the two groups. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The MAIA-C showed acceptable reliability and validity in psychometric testing. Therefore, this scale may be used in studies that assess interoceptive awareness in Chinese-speaking populations who are undergoing mind-body interventions.

Acupoint Stimulation on Weight Reduction for Obesity: A Randomized Sham-Controlled Study.

Auricular acupoint stimulation has become a popular weight loss method. However, its efficacy for obesity treatment has not been fully studied. This study aimed to investigate the effect of a 10-week intervention of auricular electrical stimulation combined with auricular acupressure on weight reduction in obese outpatients. In this single-blind randomized sham-controlled study, 134 participants were randomly assigned to an experimental group receiving stimulation at true acupoints, or a sham group receiving stimulation delivered in the same manner but at sham acupoints. Each participant received nutrition counseling by a nutritionist weekly. The results showed significant differences in body mass index, blood pressure, total cholesterol, triglyceride, and leptin or adiponectin over time within the group, but not between the groups. This study could not exclude the effect of placebo and dietary consultation. Further study that adds a control group receiving no treatment is therefore needed to confirm the effects of auricular acupressure.

Quantifying psychological distress among cancer patients in interventions and scales: a systematic review.

The management of cancer-related psychological distress has been addressed in numerous studies, which have examined both the development of interventions to alleviate psychological distress as well as scales for evaluating their efficacy. In this systematic review, we examine results from randomized controlled trials (RCTs) on the relative effectiveness of interventions in reducing cancer-related psychological distress and the scales employed to measure this distress. An electronic database search for RCTs of psychological interventions in cancer patients from October 2008 to July 2013 was conducted using PubMed, MEDLINE, and CINAHL. Data was independently extracted and assessed by two researchers. Nineteen RCTs on interventions for psychological distress were identified and analyzed, among which eight studies reported that the interventions had a positive effect and improved the symptoms of psychological distress, and in which seven main instruments were used to measure psychological distress. The most frequently employed interventions were exercise training, cognitive behavioral therapy, and complementary therapy, followed by meeting with a psychologist and a combination of keeping a written journal and peer counseling. The three most frequently employed scales were the Profile of Mood States-Short Form (POMS-SF), Distress Thermometer (DT), and Hospital Anxiety and Depression (HADS). The majority of cancer patients experience considerable psychological and emotional distress at some time during the course of the disease. Reports have shown that interventions such as exercise training, cognitive behavioral therapy, and complementary therapy can assist oncology personnel in alleviating this distress. Future studies should consider optimizing such interventions. The POMS-SF scale, which has frequently been employed to measure the effects of psychological distress, could be incorporated into elements of screening programs for measuring unfulfilled needs, desire for assistance, clinical response, and longitudinal outcomes.

Auricular acupressure to improve menstrual pain and menstrual distress and heart rate variability for primary dysmenorrhea in youth with stress.

Background. Dysmenorrhea and accompanying symptoms can have a negative impact on academic achievement, physical activity and functioning, and quality of life. Unfortunately, stress increases the sensitivity and severity of pain, activating sympathetic responses while inhibiting parasympathetic responses. Objective. This study used objective, physiological measurements to evaluate the effects of auricular acupressure on menstrual pain and menstrual distress in young college students with primary dysmenorrhea across two menstrual cycles. The aim was to determine if significant differences could be detected between the intervention and follow-up phases after controlling life stress. Design. A one-group experimental research design was used, and repeated measurements and followups were done. Thirty-two women completed questionnaires and physiological parameters were measured. Results. Significant differences between the intervention and follow-up phases were found for high frequency (HF) and blood pressure on day 1 and no significant differences in menstrual pain and menstrual distress, heart rate variability, low frequency (LF), LF/HF ratio, or heart rate. Conclusion. Auricular acupressure effectively increases parasympathetic activity to maintain autonomic function homeostasis in young women with primary dysmenorrhea and may have a value in alleviating menstrual pain and menstrual distress in a high-stress life. Future studies should consider stress, stimulus dose of auricular acupressure, severity of menstrual pain, and a longitudinal research design.