Effectiveness of Physical Exercise on Alzheimer's disease. A Systematic Review.

OBJECTIVE: A systematic review of randomized controlled trials was conducted to determine the effect of physical exercise on physical-functional capacity, cognitive performance, neuropsychiatric symptoms, and quality of life in a population of older people with Alzheimer´s disease. DATA SOURCES: Pubmed, Scopus, PEDro, Web of Science, CINAHL, Cochrane Library, grey literature and a reverse search from inception to April 2021 were searched to identify documents. STUDY SELECTION: Publications investigating the effect of any type of physical exercise-based intervention in any of its multiple modalities on physical-functional capacity, cognitive performance, neuropsychiatric symptoms, and quality of life were searched. DATA EXTRACTION: The data were extracted into predesigned data extraction tables. Risk of bias was evaluated through the PEDro scale and its internal validity scale. DATA SYNTHESIS: A total of 8 different randomized controlled trials with a total sample of 562 non-overlap Alzheimer disease patients between 50-90 years and a mean age of 75.2 ± 3.9 years were eligible for analyses. Physical-functional capacity was evaluated in 6 of 8 studies and cognitive performance was evaluated in 5 of 8 studies, all of them showed improvements in these variables when compared with the controls, except for two studies in physical-functional capacity and one study for cognitive performance. In the physical-functional capacity and cognitive performance variables, aerobic physical exercise was used in isolation, or in a multimodal way, combining aerobic, strength and balance exercise, from 2 to 7 weekly sessions with doses between 30 and 90 minutes, and a duration of the program comprised of 9 weeks to 6 months. Neuropsychiatric symptoms and quality of life were evaluated in 2 of 8 studies, which the intervention groups experienced significant improvements when compared with the control groups, except for one study that found similar differences in quality of life between both groups. In the neuropsychiatric symptoms and quality of life variables, only aerobic physical exercise was used, in a more homogeneous way, from 2 to 3 weekly sessions with doses of 30 to 60 minutes, and a total program duration of 9 to 16 weeks. CONCLUSIONS: Despite the scarcity of studies, especially those based on multimodal proposals, and the heterogeneity in the protocols, this systematic review found moderate to limited evidence that aerobic physical exercise on its own or combined in a multimodal program that also includes strength and balance exercise can be a useful tool in the management of patients with Alzheimer's disease with the aim of maintaining and/or improving physical-functional capacity and cognitive performance. In addition, this review found moderate evidence of the positive impact that aerobic physical exercise could have in reducing neuropsychiatric symptoms and improving quality of life in patients with Alzheimer´s disease. PROSPERO registration number: CRD42021229891.

The associations between menopausal symptoms and sleep quality in Spanish postmenopausal women.

Objectives: Around the menopause, sleep disturbances frequently occur or worsen and are associated with decreased health quality and physical and psychological problems. The aim of this study was to analyze sleep quality and its association with the impact of menopausal symptoms in Spanish postmenopausal women. Methods: A total of 278 postmenopausal women (age 60.95 ± 8.01 years) participated in this cross-sectional study. The Medical Outcomes Study Sleep Scale (MOS-SS) and the Menopause Rating Scale (MRS) were used to analyze sleep quality and severity of menopausal symptoms, respectively. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Results: The linear regression showed that a greater impact of menopausal symptoms (MRS total score) was associated with worse scores regarding sleep adequacy (p < 0.001, R2 = 0.056), snoring (p = 0.020, R2 = 0.036), awaken short of breath (p < 0.001, R2 = 0.089), and quantity of sleep (p < 0.001, R2 = 0.075) domains. Anxiety (p < 0.001) and worse somatic symptoms (p = 0.001) were related to greater sleep disturbances (R2 = 0.164). We also found relationships of heightened psychological symptoms (p < 0.001) and low physical activity level (p = 0.003) with increased daytime somnolence (R2 = 0.064). Finally, higher MRS total score and anxiety levels were associated with worse sleep quality assessed by MOS-SS Sleep Problems Index I (R2 = 0.179, p < 0.001 and p = 0.001, respectively) and Sleep Problems Index II (R2 = 0.146, p < 0.001 and p = 0.011, respectively). Conclusions: Anxiety and severity of menopausal symptoms were associated with poorer sleep quality. Furthermore, low physical activity level and worse psychological symptoms in menopause were predictors for increased somnolence. Therefore, screening for these factors in postmenopausal women is important, since they may be susceptible for intervention.

Influencia de la práctica deportiva sobre la huella plantar en atletas españoles / Influence of sport practice on the footprint in Spanish athletes

El objetivo de este estudio fue conocer la asociación entre el entrenamiento de atletas con las características de cada pie. Se midieron y compararon las huellas plantares de tres grupos de deportistas (28 velocistas, 29 fondistas, 47 nadadores) y de 67 sujetos no entrenados (GC). Para la captura de parámetros plantares se empleó una plataforma de escaneado podálico Podoscanalycer®. El índice podálico, metatarsal, medio podálico, y calcáneo fue inferior en GC respecto a corredores de velocidad, fondo, y nadadores (p<0.001). El riesgo relativo de tener un pie cavo o un tipo de pié específico por pertenecer a una determinada modalidad atlética no resulto significativo (todos p>0.05). Se concluye que los años de entrenamiento y la edad en atletas españoles no se asocian significativamente con la curvatura y tipología del pie ni sobre ningún índice plantar específico. Sin embargo, sexo e IMC se asocia significativamente con los índices plantares según la modalidad atlética (AU)

The aim of the present study was to determine the association between athletic training and characteristics of each foot. Plantar foot print of three groups of athletes (28 sprinters, 29 distance runners, 47 swimmers) and 67 sedentary subjects (CG) were measured and compared. A scanning platform breech Podoscanalyzer was employed to obtain plantar pressure measurements. The breech, metatarsal, middle breech, and calcaneus index, were lower in CG compared to sprinters, long-distance runners, and swimmers (p<0.001). The relative risk of having a cavus foot or any specific type of foot as a result of practicing a particular athletic discipline was not significant (all p>0.05). We conclude that the years of training and the age are not significantly associated neither with the curvature and the type of the foot nor with any specific plantar arch index in Spanish athletes. Nevertheless, sex and BMI are significantly associated with the plantar arch indexes according to the athletic discipline (AU)

Fall prevention in postmenopausal women: the role of Pilates exercise training.

Falls and fall-related injuries are a major public health concern for postmenopausal women. Fear of falling, impairments in gait and postural control, and changes in body composition have been identified as important risk factors for falling. Physical exercise is an important tool in fall prevention and management. The Pilates method is a non-impact activity that can be adapted to different physical conditions and health status and is recommended for various populations. In postmenopausal women, it has been deemed an effective way to improve some fall-related physical and psychological aspects, such as postural and dynamic balance. In addition, some physical capacities, such as flexibility, personal autonomy, mobility, and functional ability have also shown to benefit from Pilates interventions involving women in their second half of life, as well as certain psychological aspects including fear of falling, depressive status, and quality of life. Pilates exercise has shown effectively to prevent falls in postmenopausal women by improving their balance, physical and psychological functioning, and independence. Nevertheless, further studies are needed to demonstrate its validity in different clinical situations.

Effects of 6 Weeks of Balance Training on Chronic Ankle Instability in Athletes: A Randomized Controlled Trial.

The objective of the present study was to determine the effectiveness of a 6-week balance training program on patients with Chronic Ankle Instability (CAI) in relation to the results obtained in Dynamic Balance, subjective feeling of instability and pain using a single-blind randomized controlled trial. 70 athletes were randomly assigned to control or intervention group. The control group performed their usual training, and the intervention group was administered the same usual activity in addition to a balance program. The paired t-test was performed to evaluate the change scores in each group. The t-test for independent samples was performed to evaluate between-group differences in change scores. Significance level was assigned for p-values less than 0.05 for all analyses. There were significant differences between groups in change scores in CAIT and all of the SEBTs reach distances (p<0.001) but not in Pain (p=0.586). The effect sizes were larger for the outcomes measures that showed significant differences. In the within-group change, the experimental groups showed larger effect sizes in CAIT, SEBT posteromedial and SEBT posterolateral, and moderate effect sizes in SEBT anterior. Exercise therapy training based on multi-station balance tasks led to significant improvements in dynamic balance and self-reported sensation of instability in patients with CAI.

Effects of an anaerobic lactic training session on the postural stability of athletes.

AIM: The aim of this study was to analyze the short-term effects of a lactate-accumulation training session on postural stability. METHODS: Fifteen athletes performed two trainings sessions (warm-up and lactic-training session). Before training (Pre), immediately after (Post(0min)), thirty minutes later (Post(30min)) and after 24 hours (Post(24h)), athletes were subject to a bipodal and a monopodal stabilometries and a lactate blood analysis to ensure a high stress level. RESULTS: Variance analysis (α=0.05) showed that, in lactic training, athletes experienced an increase of length and velocity in post(0min), a decrease at post(30min) and a new decrease at post(24h), which was lower than basal values. In monopodal stability, left-leg support showed a decrease at post(0min) in anteroposterior plane of athletes after lactic training. Also, in both monopodal supports, athletes displayed higher values of length and velocity in post(0min) after lactic training, with a progressive decrease which was significant at Post(24h), when they reached baseline. CONCLUSION: Right after anaerobic lactic training, center-of-pressure dispersion variables in bipodal stabilometry are worsened. Thirty minutes later, stabilometric variables are still deteriorated. At 24 hours, stabilometry is better than baseline. In monopodal support, dispersion values are worsened after lactic training and anteroposterior stability is impaired in left monopodal support, although the deterioration is less evident as time passes.

Quercetin effects on weight gain and caloric intake in exercised rats.

Quercetin is a flavonoid which activates oxidative metabolism. Quercetin may reduce weight gain by decreasing feed efficiency. The present study aims to evaluate weight gain, caloric intake and feed efficiency in exercised and sedentary rats supplemented with quercetin. Wistar rats were divided into four groups: quercetin-exercise training (QT), quercetin-sedentary (QS), placebo-exercise training (PT) and placebo-sedentary (PS). Rats were exercised and/or orally supplemented with quercetin (25 mg · kg(-1) on alternate days) during six weeks. Weight gain of the QT group decreased when compared with the PT and PS groups. Exercised groups increased cumulative caloric intake during the experimental period. The QT group rats also reduced their feed efficiency when compared with the QS and PS groups. These results suggest that quercetin is not able to decrease weight gain because no differences were found between placebo and quercetin condition either in the sedentary or in the training condition.

Oral quercetin supplementation hampers skeletal muscle adaptations in response to exercise training.

We aimed to test exercise-induced adaptations on skeletal muscle when quercetin is supplemented. Four groups of rats were tested: quercetin sedentary, quercetin exercised, placebo sedentary, and placebo exercised. Treadmill exercise training took place 5 days a week for 6 weeks. Quercetin groups were supplemented with quercetin, via gavage, on alternate days throughout the experimental period. Sirtuin 1 (SIRT1), peroxisome proliferator-activated receptor γ coactivator-1α mRNA levels, mitochondrial DNA (mtDNA) content, and citrate synthase (CS) activity were measured on quadriceps muscle. Redox status was also quantified by measuring muscle antioxidant enzymatic activity and oxidative damage product, such as protein carbonyl content (PCC). Quercetin supplementation increased oxidative damage in both exercised and sedentary rats by inducing higher amounts of PCC (P < 0.001). Quercetin supplementation caused higher catalase (P < 0.001) and superoxide dismutase (P < 0.05) activity in the non-exercised animals, but not when quercetin is supplemented during exercise. Quercetin supplementation increased SIRT1 expression, but when quercetin is supplemented during exercise, this effect is abolished (P < 0.001). The combination of exercise and quercetin supplementation caused lower (P < 0.05) mtDNA content and CS activity when compared with exercise alone. Quercetin supplementation during exercise provides a disadvantage to exercise-induced muscle adaptations.

Tissue damage markers after a spinal manipulation in healthy subjects: a preliminary report of a randomized controlled trial.

Spinal manipulation (SM) is a manual therapy technique frequently applied to treat musculoskeletal disorders because of its analgesic effects. It is defined by a manual procedure involving a directed impulse to move a joint past its physiologic range of movement (ROM). In this sense, to exceed the physiologic ROM of a joint could trigger tissue damage, which might represent an adverse effect associated with spinal manipulation. The present work tries to explore the presence of tissue damage associated with SM through the damage markers analysis. Thirty healthy subjects recruited at the University of Jaén were submitted to a placebo SM (control group; n = 10), a single lower cervical manipulation (cervical group; n = 10), and a thoracic manipulation (n = 10). Before the intervention, blood samples were extracted and centrifuged to obtain plasma and serum. The procedure was repeated right after the intervention and two hours after the intervention. Tissue damage markers creatine phosphokinase (CPK), lactate dehydrogenase (LDH), C-reactive protein (CRP), troponin-I, myoglobin, neuron-specific enolase (NSE), and aldolase were determined in samples. Statistical analysis was performed through a 3 × 3 mixed-model ANOVA. Neither cervical manipulation nor thoracic manipulation did produce significant changes in the CPK, LDH, CRP, troponin-I, myoglobin, NSE, or aldolase blood levels. Our data suggest that the mechanical strain produced by SM seems to be innocuous to the joints and surrounding tissues in healthy subjects.

Effect of combined electrostimulation and plyometric training on 30 meters dash and triple jump.

AIM: The aim of this paper was to analyze the effects of training combining plyometrics (PT) and neuromuscular electrostimulation (ES) on speed training and triple jump. The study consisted on the application of an electrostimulation protocol and plyometric jumps to four groups of young athletes (Control, G II, G III and G IV). METHODS: Eighty-four young athletes took part in the study (40 girls and 44 boys). All of them were sprinters (100 and 200 meters dash, and 100 and 110 hurdles meters), their mean age, weight and height being 15.9±1.4 years old, 58.53±8.05 kg, and 1.68±0.07 m, respectively. After 8 weeks of training, a 30-meter sprint launched test -time being measured by photoelectric cells - and a triple jump test from static position were completed. Repeated measures ANCOVA were used. RESULTS: The only group that improved significantly in the speed test (P<0.001) relative to the control group was G IV. In the triple jump test, improvements were significant, (P<0.05) and (P<0.01), in G II and G IV, respectively, relative to the control group. The results of ES + PT combined training offered no significant differences in either speed test and triple jump by gender. CONCLUSION: The most effective training aimed at improving the speed of 30 m is simultaneous combined training. Regarding triple jump, the results showed significant improvements in the performance of athletes who used both simultaneous combined training and used ES followed by plyometrics. However, no significant improvement was observed after PT training prior to ES.

Regulatory systems in bone marrow for hematopoietic stem/progenitor cells mobilization and homing.

Regulation of hematopoietic stem cell release, migration, and homing from the bone marrow (BM) and of the mobilization pathway involves a complex interaction among adhesion molecules, cytokines, proteolytic enzymes, stromal cells, and hematopoietic cells. The identification of new mechanisms that regulate the trafficking of hematopoietic stem/progenitor cells (HSPCs) cells has important implications, not only for hematopoietic transplantation but also for cell therapies in regenerative medicine for patients with acute myocardial infarction, spinal cord injury, and stroke, among others. This paper reviews the regulation mechanisms underlying the homing and mobilization of BM hematopoietic stem/progenitor cells, investigating the following issues: (a) the role of different factors, such as stromal cell derived factor-1 (SDF-1), granulocyte colony-stimulating factor (G-CSF), and vascular cell adhesion molecule-1 (VCAM-1), among other ligands; (b) the stem cell count in peripheral blood and BM and influential factors; (c) the therapeutic utilization of this phenomenon in lesions in different tissues, examining the agents involved in HSPCs mobilization, such as the different forms of G-CSF, plerixafor, and natalizumab; and (d) the effects of this mobilization on BM-derived stem/progenitor cells in clinical trials of patients with different diseases.

Predictive value of stabilometry and fear of falling on falls in postmenopausal women.

OBJECTIVES: Falls are one of the leading causes of fractures and impaired quality of life in the elderly, and they are related to balance deficit and to fear of falls. The purpose of our study is to evaluate predictors of falls in the 50-65-year-old postmenopausal population. METHODS: A prospective cohort study was conducted on 96 postmenopausal women. Fear of falling and postural stability were assessed by using the FES-I (Falls Efficacy Scale-International) and a force platform, respectively. Fall frequency was determined in the 12-month follow-up study period. Multivariate logistic regression was used to identify predictive factors of falls. RESULTS: Fear of falls, the FES-I scale and four stabilometric parameters, specifically under eyes-closed condition, were significantly higher in the group of fallers. The root mean square amplitude in the medial-lateral direction with eyes closed (RMSXec) (odds ratio 5.1, 95% confidence interval (CI) 1.6-15.5, p = 0.004) and FES-I (odds ratio 3.4, 95% CI 1.1-10.5, p = 0.026) were the best independent predictive factors of the risk of falling. CONCLUSIONS: RMSXec > 0.133 was the best predictive factor for falls in our group of 50-65-year-old postmenopausal women studied, and a FES-I score > 20 could predict falls in this population.

Estudio comparativo del índice de masa corporal y el equilibrio postural en estudiantes universitarios sanos / Comparative study of the body mass index and postural balance in young healthy university students

Objetivos El propósito de este estudio ha sido analizar en una población de jóvenes universitarios la influencia del índice de masa corporal (IMC) en el equilibrio general, antero-posterior y medio-lateral.Material y métodoSe ha trabajado con una muestra de 68 jóvenes (edad=20,82±3,46), 18 hombres y 50 mujeres, universitarios. Se analizó el IMC y el equilibrio con ojos abiertos y con ojos cerrados de cada uno de los sujetos.ResultadosTodas las variables estabilométricas presentan fuerte evidencia contra la normalidad. Por ello se utilizó el coeficiente de correlación Rho de Spearman. En la relación del índice de masa corporal (IMC) con el índice de estabilidad antero-posterior ojos cerrados (IAPOCX) se observan resultados estadísticamente significativos (p=0,042). El coeficiente de determinación R2=0,037 indica que la influencia del IMC sobre el IAPOCX es del 3,7%. En el resto de variables relacionadas y llevadas a estudio no se obtuvieron resultados estadísticamente significativos.ConclusionesPodemos afirmar que en ausencia de patología relevante, cuando el sujeto se encuentra con los ojos cerrados cuanto mayor es el IMC, peor es la estabilidad en el plano sagital (AU)

Objective The purpose of this study was to analyze the influence of the Body Mass Index (BMI) on the anterior-posterior and middle-lateral postural balance in young and healthy university students.Material and methodsThe study included a sample of 68 healthy university students (50 female and 18 male) aged 18-35 years old. BMI and postural balance control with both open and closed eyes were studied in each of the subjects.ResultsAll the stabilometric parameters showed strong evidence against normality. Therefore, the Spearman's rank correlation coefficient was used. Statistically significant results were found between Body Mass index (BMI) and anterior-posterior postural balance control with closed eyes (APPBCOE) (P=0.042). The R2=0.037 Coefficient of Determination showed that the influence of BMI on APPBCOE was 3.7%. No statistically significant results were obtained for the other related variables studied.ConclusionsWe can establish that, in absence of an important condition, a high BMI is related to worse postural balance control with closed eyes in the sagittal plane (AU)

Tumour malignancy loss and cell differentiation are associated with induction of gef gene in human melanoma cells.

BACKGROUND: Gene therapy is a new method used to induce cancer cell differentiation. Our group previously showed that transfection of the gef gene from Escherichia coli, related to cell-killing functions, may be a novel candidate for cancer gene therapy. Its expression leads to cell cycle arrest unrelated to the triggering of apoptosis in MS-36 melanoma cells. OBJECTIVES: To determine the basis of the antiproliferative effect of the gef gene in this cell line. METHODS: Transmission electron microscopy, apoptosis analysis by confocal microscopy, flow cytometry and immunocytochemical analysis were used. RESULTS: Ultrastructural analysis showed a strikingly different morphology after treatment with dexamethasone and expression of the gef gene, with large accumulations of pigment throughout the cell cytoplasm and presence of melanosomes in different stages of development. High mitochondrial turnover and myeloid bodies, characteristics of neurone cells, were also observed. In addition, both immunocytochemical and indirect immunofluorescence analysis demonstrated a significant decrease in HMB-45, Ki-67 and CD44 antigen expression and an increase in S100 and p53 expression in gef gene-transfected MS-36 melanoma cells that were correlated with the duration of dexamethasone treatment. In the present work, we report that gef gene not only reduces cell proliferation in transfected melanoma MS-36TG cell line but also induces morphological changes clearly indicative of melanoma cell differentiation and a reduction in tumour malignancy. CONCLUSIONS: These findings support the hypothesis that the gef gene offers a new approach to differentiation therapy in melanoma.

Role of the organization of subjects and the educational resources used in their teaching in the Anatomy education-learning process

Within the three-year nursing degree course in Spain, the way in which anatomy teaching is organised shows distinct differences between different universities. At the University of Jaén, first-year students have human anatomy (HA) as a separate subject, whereas at the University of Almeria, anatomy is included within a larger module called the structure and function of the human body (SFHB). The aim of this study was to analyze the reaction of students to the organization of their anatomy courses, the resources used in their teaching, their contents, and the tutoring and evaluation system. For this purpose, a 35-item questionnaire was designed to address aspects related to these objectives and administered at the end of the 2005-6 academic year to 82 students of taking human anatomy at the University of Jaén and 52 students taking structure and function of human body at the University of Almeria. Results obtained showed differences in the evaluation of the educational organization of these subjects at the two universities. The approval rating of Jaen students for the relationship between their theoretical and practical education/training was 25% lower than that of Almeria students. This difference appears to be related to the different distributions of credits between the two subjects in the courses surveyed. Students appeared more highly to value the resources that were most frequently used during the course, suggesting that students may value most highly those resources employed most frequently within a course. There were some similarities between the students at the different universities in the importance they assigned to the different thematic units of the respective subjects. Finally, both groups revealed a preference for face-to-face tutorial sessions and for evaluation by written examinations (AU)

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Pedagogic evaluation of anatomical teaching for a medical and surgical degree at the University of Granada

Anatomy has been classically considered as a basic foundation for the teaching of medicine, developing a decisive role in medical education and for future professional activity. But, in common with other scientific disciplines, it has grown simultaneously with technology and communication sciences and in a much prescribed manner. The purpose of our study was to estimate different parameters related to the quality of the anatomical teaching at the University of Granada. In trying to achieve this, we have focused on the Human Anatomy I and II courses (given in the first and second years of the medical degree respectively). Once the examinations in these courses were completed, a questionnaire was filled by the students in which they had to estimate, in a one to five range, the adaptation and the adjustment of different aspects related to the development of the course. The results indicated that the students were in favour of practical classes compared to theoretical tuition. On the other hand, the pedagogical organisation of the courses was highly valued by the students, particularly in relation to the adaptation of programme objectives and to the recommended bibliography (both for textbooks and atlases). The best estimated didactic resource for the practical aspect of the subject was the use of human anatomical specimens, and the most favoured procedure in the theoretical classes was the use of the blackboard. For the examinations and assessments, no special preference for any evaluation method was found, but the use of complementary papers (e.g. use of monographs, oral expositions) was considered by the students to be of very little importance (AU)

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Release of alpha-actin into serum after skeletal muscle damage.

OBJECTIVE: The skeletal muscle protein alpha-actin was investigated in the serum of subjects with severe skeletal muscle damage to assess its utility as a reliable and predictive marker of muscle damage. METHODS: Serum samples were obtained from 33 healthy controls and 33 patients with severe skeletal muscle damage, defined by a total creatine kinase value of >500 IU/l (Rosalki method). Troponin I, troponin T, and myoglobin concentrations were determined by immunoassay and alpha-actin concentrations by Western blot and densitometry. RESULTS: The mean serum concentration of alpha-actin in controls and patients with skeletal muscle damage was 600.9 and 1968.51 ng/ml, respectively, a statistically significant difference. Sera of patients with muscle damage showed higher levels of alpha-actin than of troponin or myoglobin. No significant difference in troponin I levels was observed between the groups. CONCLUSIONS: According to these results, alpha-actin was the most significant skeletal muscle damage marker analysed and may be an ideal candidate for the identification of all types of myofibre injury, including sports injuries. Our findings support the use of alpha-actin as a marker alongside other currently used biological proteins.