The Effects of Stepping Exercise on Blood Pressure, Physical Performance, and Quality of Life in Female Older Adults with Stage 1 Hypertension: a Randomized Controlled Trial.

Background: Hypertension is a common disease, particularly in older adults. In a previous study, we found that an eight-week course of stepping exercise improved physical performance in healthy older adults as measured using the six-minute walk test (468 vs. 426 m in controls; p = .01). This study aims to further evaluate the effects of stepping exercise on blood pressure, physical performance, and quality of life in older adults with stage 1 hypertension. Methods: This was a randomized, controlled trial comparing older adults with stage 1 hypertension who performed stepping exercise with controls. The stepping exercise (SE) was performed at moderate intensity three times/week over an eight-week period. Participants in the control group (CG) received verbal and written (pamphlet) lifestyle modification advice. Blood pressure at Week 8 was the primary outcome, while quality of life score and physical performance on the 6-minute walk test (6MWT), timed up and go test (TUGT), and five times sit to stand test (FTSST) were secondary outcomes. Results: There were 17 female patients in each group (total of 34). After eight weeks of training, participants in the SE group showed significant improvements in systolic blood pressure (SBP; 132.0 vs. 145.1 mmHg; p<.01), diastolic blood pressure (DBP; 67.3 vs. 87.6 mmHg; p<.01), 6MWT (465.6 vs. 437.0; p<.01), TUGT (8.1 vs. 9.2 sec; p<.01), and FTSST (7.9 vs. 9.1 sec; p<.01) compared to controls. Regarding within-group comparison, participants in the SE also showed significant improvement in all outcomes from baseline, while any such outcomes in the CG were comparable from baseline (SBP: 144.1 to 145.1 mmHg; p = .23; DBP: 84.3 to 87.6 mmHg; p = .90). Conclusions: The stepping exercise examined is an effective non-pharmacological intervention for blood pressure control in female older adults with stage 1 hypertension. This exercise also resulted in improvements in physical performance and quality of life.

An Ancient Boxing Exercise Improves Physical Functions, Balance, and Quality of Life in Healthy Elderly Persons.

It has been shown that traditional dances can be effective in improving physical functions in the elderly persons. Unlike other traditional dance exercises, the ancient Thai boxing exercise may be suitable for elderly persons in other ethnicities who are interested in boxing. This randomized controlled study aimed to evaluate the effects of the exercise on physical functions in elderly subjects. Healthy elderly subjects were recruited and randomly divided into two groups: the control group and the ancient Thai boxing group. The control group received education about the exercise and a home program of daily practice. The ancient Thai boxing group performed the modified ancient Thai boxing exercise for 12 weeks. There were six outcomes in this study which were recorded at baseline and at the end of study (week 12) including a six-minute walk test (6MWT), five times sit to stand test (FTSST), flexibility by trunk flexometer, time up and go test (TUGT), and Berg balance scale (BBS), as well as a test to determine quality of life (QOL). All outcomes were compared to the baseline, as well as between groups. There were 56 subjects enrolled in the study, 28 in the control group, and 28 in the ancient Thai boxing group, with mean ages of 68.6 and 65.9 years, respectively. The majority of subjects in both groups were women (96.4% and 89.3%). After 12 weeks of study, significant differences were found in terms of all seven outcomes between the two groups. For example, the 6MWT in the control group was 415.8 vs 480.3 m in the ancient boxing group. In conclusion, the 12-week ancient boxing exercise significantly improved physical functions, balance, and QOL in the elderly.

Effects of the applied ancient boxing exercise on leg strength and quality of life in patients with osteoarthritis.

This study aimed to investigate the effect of ancient boxing exercise on the strength of leg muscles and quality of life in patients with osteoarthritis. The subjects were divided into 2 groups, control group (CG) and experimental group (EG). The average aged of control and experimental group were 60.3±6.8 and 59.0±7.8 years, respectively. All volunteers were interviewed for basic information, evaluation of the criteria of research and sign consent to participate in the research. The outcome measurement consisted of five time sit to stand test, 6-min walk test, flexibility by sit and reach test, Berg Balance Scale, Timed Up and Go Test, knee injury and osteoarthritis outcomes score (KOOS) and quality of life of World Health Organization Thai brief version (WHOQOL-BERF-THAI). Prior and posttest measurements were performed at 0, 4, 8, and 12 weeks, and those who received ancient boxing exercise were given 60 min 3 times per week for 12 weeks. The results of the study showed that postexercise leg muscle strength, physical performances, quality of life and KOOS increased significantly after exercise. In conclusion, the ancient boxing exercise could increase the strength of leg muscles physical performances, quality of life in people with knee osteoarthritis. This exercise can be used as a long lasting exercise in the future.

Effect of yoga on the menstrual pain, physical fitness, and quality of life of young women with primary dysmenorrhea.

The aim of the present study was to investigate effect of specially designed yoga program on the menstrual pain, physical fitness, and quality of life (QOL) of non-athlete women with primary dysmenorrhea (PD) aged 18-22 years. Thirty-four volunteers were randomly assigned into control and yoga groups. Menstrual pain, physical fitness, and QOL were evaluated at baseline and at the end of the 12-week study period. The yoga group was asked to practice yoga for 30 min per day, twice a week, for 12 weeks at home, while the control group did not receive any form of exercise over the study period. There were significant improve in menstrual pain, physical fitness, and QOL in the yoga group more than the control group. Therefore, this specially designed yoga program may be a possible complementary treatment for PD.

Transient Changes in Brain Metabolites after Transcranial Direct Current Stimulation in Spastic Cerebral Palsy: A Pilot Study.

BACKGROUND: Muscle spasticity is a disability caused by damage to the pyramidal system. Standard treatments for spasticity include muscle stretching, antispastic medications, and tendon release surgeries, but treatment outcomes remain unsatisfactory. Anodal transcranial direct current stimulation (tDCS) in patients with muscle spasticity is known to result in significant improvement in spastic tone (p < 0.001). However, the mechanism of action by which tDCS treatment affects spasticity remains unclear. This pilot study aimed to investigate the effect of anodal tDCS upon brain metabolites in the left basal ganglia and ipsilateral primary motor cortex (M1) in children with spastic cerebral palsy (CP). MATERIALS AND METHODS: This study consisted of three steps: a baseline evaluation, a treatment period, and a follow-up period. During the treatment period, patients were given 20 min of 1 mA anodal tDCS over the left M1 for five consecutive days. Outcomes were compared between pre- and immediate posttreatment in terms of brain metabolites, Tardieu scales, and the quality of upper extremity skills test. RESULTS: Ten patients with spastic CP were enrolled. Following tDCS, there were significant increases in the ratio of N-acetylaspartate (NAA)/creatine (Cr) (p = 0.030), choline (Cho)/Cr (p = 0.043), and myoinositol (mI)/Cr (p = 0.035) in the basal ganglia. Moreover, increased glutamine-glutamate (Glx)/Cr ratio in the left M1 (p = 0.008) was found. In addition, we also observed improvements in the extent of spasticity and hand function (p = 0.028). CONCLUSION: Five consecutive days of anodal tDCS over the left M1 appeared statistically to reduce the degree of spasticity and increase NAA, Cho, mI, and Glx. Future research studies, involving a larger sample size of spastic CP patients undergoing tDCS is now warranted.

The Gross Motor Function Classification System Family Report Questionnaire: reliability between special-education teachers and caregivers.

AIM: The aim of this study was to investigate the reliability of the Thai Gross Motor Function Classification System Family Report Questionnaire (GMFCS-FR) and the possibility of special-education teachers and caregivers in the community using this system in children with cerebral palsy (CP). METHOD: The reliability was examined by two teachers and two caregivers who classified 21 children with CP aged 2 to 12 years. A GMFCS-FR workshop was organized for raters. The teachers and caregivers classified the mobility of 362 children. The rater reliability was analysed using the weighted kappa coefficient. The possibility of using the GMFCS-FR is reported. The reliability of using the GMFCS-FR in the community was analysed by the intraclass correlation coefficient. RESULTS: The intrarater reliability ranged from 0.91 to 1.00. The interrater reliability between teachers was 0.85 (95% confidence interval [CI] 0.69-0.97) and between caregivers was 0.84 (95% CI 0.70-0.97). Ninety-seven percent of raters used the Thai GMFCS-FR correctly. The overall intraclass correlation coefficient between raters was 0.90 (95% CI 0.88-0.92). INTERPRETATION: The Thai GMFCS-FR is a reliable system for classifying the motor function of young children with CP by teachers and caregivers in the community.

Modified stepping exercise improves physical performances and quality of life in healthy elderly subjects.

BACKGROUND: Stepping exercise, an aerobic exercise, has been shown to be beneficial to elderly people if performed continuously for at least 12 weeks. This study aimed to evaluate the effects of engaging in modified stepping exercise on stairs with shorter height than the standard stepping platform for a shorter duration (8 weeks) on both physical fitness and quality of life (QoL) in healthy elderly subjects by using a randomized controlled trial. METHODS: The study was conducted at the Elderly Club, Muang District, Khon Kaen, Thailand. The study examined healthy elderly subjects aged 60-80 who had not engaged in regularly exercise in the past two months and no contraindication for exercise. Eligible subjects were randomly assigned to either the stepping exercise group (SG) or control group (CG). The SG performed stepping exercise together in groups three times a week for eight weeks, while the CG received general health education. Stepping exercise was performed for one hour on a one-step platform that was 18 centimeters in height. Physical performance was measured at the baseline and the end of the study. This included a six-minute walk distance test (6MWT), a five times sit to stand test (FTSST), a timed up and go test (TUGT), a functional reach test (FRT) and a QoL assessment. RESULTS: In total, 42 subjects were enrolled, half of which were randomly assigned to the SG and the other half assigned to the CG. The median age of both groups was equal at 69 years. Other baseline characteristics were comparable. None of the outcomes differed between the two groups baseline. However they showed statistically significant differences at the end of study, with the exception of FTSST. After 8 weeks, the SG performed significantly better on the 6MWT (468 vs. 426 m; P=0.01), TUGT (5.96 vs. 8.52 sec; P<0.01), and FRT (28 vs. 21 cm; P<0.01) and had a better QoL score (105 vs. 98; P=0.03) than the CG. CONCLUSIONS: Modified stepping exercise was beneficial to the healthy elderly subjects. Physical functions and QoL significantly improved after the short duration of eight weeks.

Effects of resistance exercise on cardiopulmonary factors in sedentary individuals.

[Purpose] This study investigated the effects of resistance exercise on cardiopulmonary functions in young sedentary subjects. [Subjects] Forty-two young and healthy subjects with a sedentary lifestyle were included in this study. [Methods] The subjects were randomly divided into 2 groups: control and experimental. The control group (n=21) received health education and continued with normal activities of daily living. The experimental group (n=21) underwent resistance training, health education, and continued with normal activities of daily living. The resistance exercise program consisted of 3 postural exercises: chest press, dumbbell pullover, and flat-bench dumbbell fly. The subjects received this intervention 3 times/week for 8 weeks. [Results] The baseline characteristics were comparable between the 2 groups. The 6-minute-walk test score, peak expiratory flow, forced vital capacity, forced expiratory volume in 1 second, maximal voluntary ventilation, and chest expansions were significantly improved post-intervention in the experimental group and between the 2 groups. [Conclusion] Cardiopulmonary functions in young sedentary subjects were significantly improved with the 8-week resistance exercise program.

Responses of Six-Weeks Aquatic Exercise on the Autonomic Nervous System, Peak Nasal Inspiratory Flow and Lung Functions in Young Adults with Allergic Rhinitis.

Allergic rhinitis is a chronic respiratory disease. Sympathetic hypofunction is identified in all of the allergic rhinitis patients. Moreover, allergic rhinitis is associated with decreased peak nasal inspiratory flow (PNIF) and impaired lung functions. The aim of this study was to investigate effects of six-week of aquatic exercise on the autonomic nervous system function, PNIF and lung functions in allergic rhinitis patients. Twenty-six allergic rhinitis patients, 12 males and 14 females were recruited in this study. Subjects were diagnosed by a physician based on history, physical examination, and positive reaction to a skin prick test. Subjects were randomly assigned to two groups. The control allergic rhinitis group received education and maintained normal life. The aquatic group performed aquatic exercise for 30 minutes a day, three days a week for six weeks. Heart rate variability, PNIF and lung functions were measured at the beginning, after three weeks and six weeks. There were statistically significant increased low frequency normal units (LF n.u.), PNIF and showed decreased high frequency normal units (HF n.u.) at six weeks after aquatic exercise compared with the control group. Six weeks of aquatic exercise could increase sympathetic activity and PNIF in allergic rhinitis patients.

Cardiopulmonary effects of traditional Thai dance on menopausal women: a randomized controlled trial.

[Purpose] This study evaluated the effects of Thai dance on cardiopulmonary factors in menopausal women. [Subjects] Sixty-six menopausal women aged 40 years or more. [Methods] Subjects were randomly assigned to either the Thai dance or control group. The Thai dance group performed a traditional Thai dancing exercise program for 60 minutes, 3 times per week for 6 weeks. The control group received general health guidance. The 6-minutewalk test, peak expiratory flow, forced vital capacity, forced expiratory volume in one second, maximal voluntary ventilation, and chest expansion were assessed at baseline and at the end of the study. [Results] Sixty-six menopausal women were eligible. At the end of the study, all variables were significantly better in the Thai dance group than the control group. Moreover, all variables improved significantly compared to baseline in the Thai dance group but not in the control group. For example, the mean 6-minutewalk test result in Thai dance group at the end of the study was 285.4 m, which was significantly higher than that at baseline (254.8 m) and the control group at baseline (247.0 m). [Conclusion] A 6-week Thai dance program improves cardiorespiratory endurance in menopausal women.

Reduction of spasticity in cerebral palsy by anodal transcranial direct current stimulation.

OBJECTIVE: To evaluate the anti-spasticity effects of anodal transcranial direct current stimulation (tDCS) in individuals with spastic cerebral palsy (CP). MATERIAL AND METHOD: Forty-six children and adolescents with cerebral palsy were randomly assigned to either active (1 mA anodal) or sham (placebo) tDCS over the left primary motor cortex (Ml) on five consecutive days. Both group also received routine physical therapy. Measures of spasticity and passive range of motion (PROM) were administered before treatment, immediately after treatment, and at 24- and 48-hours follow-up. RESULTS: Participants assigned to active tDCS treatment evidenced significantly more pre- to immediately post-treatment reductions in spasticity than participants assigned to the sham (p = 0.004, p

Pain reduction in myofascial pain syndrome by anodal transcranial direct current stimulation combined with standard treatment: a randomized controlled study.

BACKGROUND: Myofascial pain syndrome (MPS) in the shoulder is among the most prevalent pain problems in the middle-aged population worldwide. Evidence suggests that peripheral and central sensitization may play an important role in the development and maintenance of shoulder MPS. Given previous research supporting the potential efficacy of anodal transcranial direct current stimulation (tDCS) for modulating pain-related brain activity in individuals with refractory central pain, we hypothesized that anodal tDCS when applied over the primary motor cortex (M1) combined with standard treatment will be more effective for reducing pain in patients with MPS than standard treatment alone. METHODS AND MATERIALS: Study participants were randomized to receive either (1) standard treatment with 5 consecutive days of 1 mA anodal tDCS over M1 for 20 minutes; or (2) standard treatment plus sham tDCS. Measures of pain intensity, shoulder passive range of motion (PROM), analgesic medication use, and self-reported physical functioning were administered before treatment and again at posttreatment and 1-, 2-, 3-, and 4-week follow-up. RESULTS: Thirty-one patients with MPS were enrolled. Participants assigned to the active tDCS condition reported significantly more pretreatment to posttreatment reductions in pain intensity that were maintained at 1-week posttreatment, and significant improvement in shoulder adduction PROM at 1-week follow-up than participants assigned to the sham tDCS condition. CONCLUSIONS: Five consecutive days of anodal tDCS over M1 combined with standard treatment appears to reduce pain intensity and may improve PROM, faster than standard treatment alone. Further tests on the efficacy and duration of effects of tDCS in the treatment of MPS are warranted.

Physical performance in recently aged adults after 6 weeks traditional Thai dance: a randomized controlled trial.

BACKGROUND: Exercise has been shown to be effective in cardiovascular endurance in the elderly. We studied the effect of Thai dancing on physical performance of Thai elderly. METHODS: This was an open-labeled, randomized intervention study. The Thai dancing group exercised for 40 minutes three times a week for 6 weeks. Physical performance ability was the primary outcome, including a 6-minute walk test (6MWT), five-times sit-to-stand (FTSST), and a sit-and-reach test measured before and after 6 weeks of intervention. RESULTS: There were 42 subjects enrolled in the study, and 38 female subjects completed (20 in Thai dance group, 18 controls), with an average age of 65.8 ± 5.1 years. The Thai dance group had significantly better physical performance in all measurements at the end of the study. The 6MWT was longer (416.7 ± 58.7 versus 345.7 ± 55.1 m; P = 0.011), FTSST was quicker (10.2 ± 1.5 versus 14.4 ± 3.3 seconds; P < 0.001), and flexibility was higher (14.9 ± 3.5 versus 11.1 ± 5.7 cm; P = 0.002) in the Thai dance group than the control group. CONCLUSION: Thai dance can improve physical performance in recently aged (elderly) female adults.

The effect of six-weeks of sauna on treatment autonomic nervous system, peak nasal inspiratory flow and lung functions of allergic rhinitis Thai patients.

BACKGROUND: Allergic rhinitis is a chronic respiratory disease. Sympathetic hypofunction has been identified in allergic rhinitis patients. OBJECTIVE: To investigate the effects of six weeks of repeated sauna treatment on the autonomic nervous system, peak nasal inspiratory flow (PNIF) and lung functions in Thai patients with allergic rhinitis. METHODS: Subjects were diagnosed with allergic rhinitis clinically by an attending physician based on history, physical examination and positive reactions to a skin prick test. Subjects were randomly assigned to two groups. Controlsubjects received education and maintained a normal life. The sauna group received sauna treatment over a six-week period, 3 days per week, with 6 sets of 5 minutes per set per day, totaling 30 minutes. Each 5 minute set alternated with a 5 minute period of rest. Heart rate variability (HRV), peak nasal inspiratory flow and lung function were measured at the beginning and after three and six weeks of sauna treatment. The HRV measurement is composed of three components, including low frequency (indicating sympathetic function in normal units or n.u.), high frequency (indicated parasympathetic function in n.u.), and the ratio of LF/HF (indicating the balance of the autonomic system). RESULTS: Twenty-six allergic rhinitis patients, 12 males and 14 females participated in this study, 13 in the control group and 13 in the sauna treatment group; there were 6 males in each group. Baseline characteristics for the control and sauna treatment groups were comparable. There were significant changes in the HRV after six weeks of sauna treatment. The high frequency component was significantly lower in sauna treatment group (51.8 vs 35.4), while the low frequency component and LF/HF ratio were significantly higher in sauna treatment group than in the control group (48.1 vs 64.5 and 0.9 vs 2.5, respectively). The PNIF and the forced expiratory volume in one second, or FEV1, were also significantly higher in sauna treatment group (103.0 vs 161.9 and 80.1 vs 95.6, respectively). CONCLUSION: The six weeks of repeated sauna treatment can increase sympathetic activity, PNIF, and FEV1 in Thai patients with allergic rhinitis.

Migraine prophylaxis by anodal transcranial direct current stimulation, a randomized, placebo-controlled trial.

BACKGROUND: Migraine is a common headache syndrome in adult populations. Prophylaxis is necessary to improve the quality of life but some patients with migraine have contraindication or suffer from side effects of medication, and therefore, establishing non-medical, neuromodulatory approaches is necessary. Past evidence had shown that consecutive motor cortex (M1) stimulation with anodal transcranial direct current stimulation (tDCS) was effective to relieve central pain. OBJECTIVE: To determine whether 20 consecutive days of the left M1 can be an effective prophylactic treatment for migraine. MATERIAL AND METHOD: Forty-two episodic migraine patients who had never received any prophylactic treatment, failed prophylactic treatment, or discontinued treatment due to adverse events were recruited in the present study. Patients were randomized to receive either active tDCS or sham tDCS 1mA, 20 m for 20 consecutive days and followed up for 12 weeks. Differences between and within groups were determined using repeated measures ANOVA. The level of significance was set at p < 0.05. RESULTS: Thirty-seven patients participated in the final analyses (active: n = 20, sham: n = 17). Between-groups comparison of attack frequency, pain intensity, and abortive medications used were performed at 4, 8, and 12 weeks after treatment. The results showed statistically significant reduction in attack frequency and abortive medications at week 4 and 8 after treatment. The pain intensity was statistically significant reduced at week 4, 8, and 12. All patients tolerated the tDCS well without any serious adverse events. CONCLUSION: The present study suggests that anodal M1 tDCS may be a safe and useful clinical tool in migraine prophylaxis. The mechanism of action of anodal tDCS on neuromodulation in migraine patients needs further investigation.

Effect of gender on fuel utilization during exercise at different intensities in untrained Thai individuals.

Research in Western populations has demonstrated a gender effect on substrate metabolism during exercise. Women have been shown to use more lipid and less carbohydrate as energy sources during endurance exercise, compared with their male counterparts. Nutritional status influences fuel utilization during exercise. Thai men and women routinely ingest a greater proportion of their dietary energy as carbohydrate than Caucasian individuals and thus may respond differently to exercise. Therefore, this study aimed to investigate the effects of gender on fuel utilization at different exercise intensities in untrained Thai individuals. Sixteen healthy sedentary men and 16 women participated in this study. All participants cycled at a target workload equivalent to 25, 65 and 85% maximum oxygen consumption continuously for 15, 10 and 10 min, respectively. Expired gas samples were collected for 30 min at rest and for the final 5 min of each exercise intensity. Actual relative exercise intensities were 32 +/- 1.7, 64 +/- 1.8, 84 +/- 1.7% maximum oxygen consumption, respectively, and there was no significant difference between genders. Carbohydrate oxidation rate was higher than fat oxidation rate at every exercise intensity in both genders. In untrained Thai individuals, gender did not affect fuel utilization during sub-maximal exercise. The higher utilization of carbohydrate than fat at rest and during exercise in Thai individuals than seen previously in other populations may be due to the Thai's habitual higher dietary carbohydrate intake.

Hepatoprotective and antioxidant activities of Tetracera loureiri.

Tetracera loureiri is one of the most valued herbs in Thai traditional medicine. In this study, we describe its in vitro and in vivo antioxidant and hepatoprotective activities. The ethanol extract of T. loureiri possessed potent antioxidant and strong free radical scavenging properties assayed using ferric reducing antioxidant power (FRAP) and 2,2-diphenyl-1-picrylhydrazyl (DPPH), respectively. The cytoprotective effects of T. loureiri were demonstrated in ethanolic extracts of freshly isolated rat hepatocytes against the chemical toxicants paracetamol and tertiary-butylhydroperoxide. The cells pretreated with the extract maintained the GSH/GSSG ratio and suppressed lipid peroxidation in a dose dependent manner. Pretreating rats with the ethanol extract orally, one hour prior to intraperitoneal injection of toxic doses of paracetamol, significantly prevented elevations of plasma ALT and AST. These results suggest that T. loureiri may be of potential therapeutic value in some liver disorders.