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Introduction: Metabolic syndrome has traditionally been associated with cardiovascular diseases and has recently been linked to increased susceptibility to COVID-19 infection, thus highlighting the need for multimodal interventions to optimize management of this condition. Aim: To assess the effects of high-intensity interval training (HIIT) alongside a low-fat diet and carboxytherapy on metabolic syndrome features. Material and methods: Sixty women (50-60 years old) diagnosed with metabolic syndrome were assigned to a 4-week intervention of either HIIT in combination with a low-fat diet and carboxytherapy (experimental group: n1 = 30, age = 54.17 ±2.82 years, body mass index (BMI) = 32.10 ±0.91), or a low-fat diet and carboxytherapy only (active control group: n2 = 30, age = 54.10 ±2.64 years, BMI = 32.12 ±1.19). Exclusion criteria were uncontrolled hypertension, diabetes mellitus, coronary artery disease, smoking, contraindications to carboxytherapy, and contraindications to exercise testing/training. Outcome measures were waist circumference (WC), BMI, serum triglycerides (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoproteins (HDL), and fasting blood glucose (FBG). Results: Both groups showed significant improvements in all outcome measures compared to baseline values (p < 0.05). The experimental group showed significantly greater improvements in mean values of WC, BMI, TG, SBP, DBP, and FBG (p < 0.05), as well as a tendency for a significant difference in HDL (p = 0.075) compared to the control group. Conclusions: The addition of HIIT to a low-fat diet and carboxytherapy could lead to greater improvements in metabolic cardiovascular risk factors in women with metabolic syndrome than a low-fat diet and carboxytherapy alone. This could suggest a good rationale for the inclusion of HIIT in the multimodal interventions rendered to women with metabolic syndrome.
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PURPOSE: We evaluated whether a surgical technique combining distal capitate shortening and arthrodesis to the base of the third metacarpal bone for the treatment of the early stages (stages II and IIIA) of Kienböck's disease with neutral ulnar variance resulted in pain relief, improvement in wrist motion, or changes in the radiographic evaluation. METHODS: This retrospective study reviewed 22 patients with early stages of Kienböck's disease with neutral ulnar variance, treated by distal capitate shortening and arthrodesis to the base of the third metacarpal bone. Patients were divided into 2 groups by disease stage: stage II (n = 12) and stage IIIA (n = 10). There were 8 women and 14 men, with an average age of 35.7 years. The following parameters were measured before and after surgery: visual analog scale (VAS) for pain evaluation, grip strength, range of motion (ROM), ulnar variance, carpal height index, lunate height index, and the scapholunate and scaphocapitate angles. The patients were evaluated in accordance with Modified Mayo Wrist Score (MMWS). RESULTS: The average follow-up period was 30.5 months (range, 26-36 months). The stage II group showed significant improvements in the mean VAS (58-5), ROM (57% to 73%), grip strength (54% to 75%), and MMWS (51-78). Patients in the stage IIIA group showed nonsignificant changes in mean VAS score (64-42.5), ROM (52.5% to 55.5%), grip strength (46.5% to 57.5%), and MMWS (36-50.5). Significant decreases in the carpal height index and scaphocapitate angle, and an increase in scapholunate angle in all stage IIIA patients were observed. CONCLUSIONS: Distal capitate shortening with capitometacarpal arthrodesis can alleviate pain and improve ROM and grip strength in patients with stage II Kienböck's disease, but not in those with stage IIIA. Moreover, it cannot prevent carpal collapse, especially in stage IIIA of the disease. We do not recommend this technique for treating stage IIIA patients. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
