Tailored Exercise in Patients with Chronic Diseases 2017

A special issue of Journal of Functional Morphology and Kinesiology (ISSN 2411-5142).

Deadline for manuscript submissions: closed (30 November 2017) | Viewed by 30274

Special Issue Editor


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Guest Editor
Sport Medicine Center, Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy
Interests: physical exercise; training; non-communicable chronic diseases; sedentary time; cardio-metabolic and inflammatory risk biomarkers; nutritional integration; functional evaluation; long-term efficacy of physical exercise; exercise prescription in non-communicable chronic disease and in solid organ transplantations; cardiotoxicity; echocardiographic deformation parameters
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Special Issue Information

Dear Colleagues,

Physical Exercise is usually suggested to reduce cardiovascular risks factors and prevent chronic metabolic diseases as a consequence of the effects on the body weight and structure, overall fitness, muscle strength, flexibility and quality of life. Regular physical training has been more recently promoted for the evidence of the “anti-inflammatory effectiveness”. A positive impact has been shown in the most common “non-communicable diseases”, such as hypertension, diabetes, metabolic syndrome, cardio-vascular diseases, elderly age, post-transplant syndrome, and also in cancer, where the inflammatory process is globally represented. The American College of Sports Medicine (ACSM) guidelines actually support “exercise as therapy” at moderate level of Energy Expenditure. The importance to establish the individual level of physical exercise, like a drug’s dose, has induced the literature in investigating this aspect in diverse context varied by sex, age, and/or race/ethnicity and especially in different clinical fields associated to an incorrect life style habits. To reach this goal a bench to bedside research strategy is needed. The Special Issue, “Tailored Exercise in Patients with Chronic Diseases”, is dedicated to collect the experience in this field and authors are invited to submit original research papers and current review articles.

Assist. Prof. Dr. Laura Stefani
Guest Editors

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Keywords

  • exercise
  • training
  • quality of life
  • sedentarism
  • metabolic syndrome
  • cancer
  • elderly
  • diabetes
  • hypertension
  • nutrition

Published Papers (7 papers)

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Research

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877 KiB  
Article
Diabetes Type 2 and Physical Activity Program: Potential Application of Risk-Engine UKPDS Score in Out-Patient Context
by Cristian Petri, Alice Tantucci, Gaia Angeloni, Giacomo Bomboletti, Gabriele Mascherini, Vittorio Bini, Massimiliano De Angelis, Giorgio Galanti and Laura Stefani
J. Funct. Morphol. Kinesiol. 2018, 3(1), 3; https://doi.org/10.3390/jfmk3010003 - 27 Dec 2017
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Abstract
Diabetes mellitus Type 2 (DMT2) carries a high risk of cardiovascular (CV) morbidity and mortality. Physical activity (PA) is widely prescribed for this population. However, detection of the eventual risk level and the potential additional increase through physical exercise are of paramount importance [...] Read more.
Diabetes mellitus Type 2 (DMT2) carries a high risk of cardiovascular (CV) morbidity and mortality. Physical activity (PA) is widely prescribed for this population. However, detection of the eventual risk level and the potential additional increase through physical exercise are of paramount importance in these patients. A model for predicting absolute risk for coronary artery disease in diabetes has been provided in the investigation by the UKPDS (United Kingdom Prospective Diabetes Study). The present study aims to verify the potential feasibility of the UKPDS calculation in an out-patient context, where patients with DMT2 can be selected for an exercise prescription program. All patients investigated were consecutively enrolled in the study at the time of the first clinical check-up in the outpatient center of the University of Perugia-Internal Medicine Department. A group of 101 Caucasian patients (62 males; 39 females; aged 67 ± 2 years) were studied. In agreement with the UKPDS score, gender, age, ethnicity, Body Mass Index, systolic blood pressure and smoking habits were considered. The global mean cardiovascular risk calculated by the UKPDS risk-engine was 25.8% of a first cardiovascular event within 10 years after the initial observation. Despite an absence of symptoms, the risk was globally high and in agreement with current literature. Conclusion: The data are suggestive of a potential large clinical application of UKPDS risk-engine score in an outpatient context, especially in those asymptomatic DMT2 patients potentially enrolled in a physical activity program. This pilot investigation supports the importance for immediate estimation of cardiovascular risk in DMT2 subjects to implement basic therapeutic strategies such as physical activity. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases 2017)
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Communication
Long-Term Benefits of Adapted Physical Activity on Upper Limb Performance and Quality of Life in Breast Cancer Survivors
by Daniela Mirandola, Marco Monaci, Guido Miccinesi, Leonardo Ventura, Maria Grazia Muraca, Elisa Casini, Eleonora Sgambati, Mirko Manetti and Mirca Marini
J. Funct. Morphol. Kinesiol. 2017, 2(4), 38; https://doi.org/10.3390/jfmk2040038 - 16 Oct 2017
Cited by 4 | Viewed by 3708
Abstract
Current evidence suggests that physical activity interventions can improve quality of life, fitness, and strength, reducing depression and fatigue in breast cancer survivors. However, in the long-term many survivors are insufficiently active. Here, the possible long-term benefits of a specific adapted physical activity [...] Read more.
Current evidence suggests that physical activity interventions can improve quality of life, fitness, and strength, reducing depression and fatigue in breast cancer survivors. However, in the long-term many survivors are insufficiently active. Here, the possible long-term benefits of a specific adapted physical activity (APA) intervention on upper limb functional performance and quality of life in breast cancer survivors were investigated. For this purpose, fifteen survivors were assessed by fitness tests (shoulder-arm mobility, range of motion, back flexibility) at the baseline and at eight weeks post-APA intervention. Quality of life and surgical shoulder and back pain intensity were evaluated by Short Form-12 and numerical rating scale questionnaires, respectively. Five participants, who continued to follow the APA protocol over time, were again evaluated after two years and compared to either five women who were inactive or five others who practiced general physical activity after ending the eight-week APA protocol. Shoulder-arm mobility and self-reported questionnaire data revealed the maintenance and/or improvement of the achieved benefits two years after the APA intervention. Our findings suggest that the long-term practice of APA tailored to individual characteristics should be recommended to breast cancer survivors in order to preserve quality of life and fitness. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases 2017)
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Article
Evaluating Human Balance Following an Exercise Intervention in Previously Sedentary, Overweight Adults
by Cody E. Morris, Harish Chander, John C. Garner, Hunter DeBusk, Scott G. Owens, Melinda W. Valliant and Mark Loftin
J. Funct. Morphol. Kinesiol. 2017, 2(2), 19; https://doi.org/10.3390/jfmk2020019 - 11 Jun 2017
Cited by 1 | Viewed by 3377
Abstract
Previous research suggests that an improvement in body composition could potentially lead to improvement in balance performance in previously overweight individuals. The purpose of this study was to evaluate if an exercise intervention without any specific balance training can lead to an improvement [...] Read more.
Previous research suggests that an improvement in body composition could potentially lead to improvement in balance performance in previously overweight individuals. The purpose of this study was to evaluate if an exercise intervention without any specific balance training can lead to an improvement in standing balance. Fourteen overweight, but otherwise healthy adults (nine females, six males) (mean age: 23.5 years; mean height: 1.70 m, mean starting body mass: 94.1 kg) participated in this study. Balance performance was assessed with sensory organization test (SOT) and motor control test (MCT) on the NeuroCom® Equitest™, prior to and after a 10-week exercise intervention. Results revealed significant improvements in the following balance parameters following exercise intervention: eyes open, sway-referenced visual surrounding and platform condition (p = 0.033) for SOT equilibrium scores; SOT center of pressure (COP) sway in the eyes closed condition for anterior-posterior sway velocity (p = 0.006) and in the eyes open sway-referenced condition (p = 0.048). The results of the current study suggest that improved balance performance can result from an exercise intervention without any specific balance directed exercises, but that the results may be limited to the conditions where the somatosensory system plays a larger role in balance maintenance. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases 2017)
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Article
Total Body Water Distribution in Breast Cancer Survivors Following Cancer Rehabilitation
by Laura Stefani, Davide Palmerini, Michele Corezzi, Gabriele Mascherini, Cristian Petri, Riggs J. Klika and Giorgio Galanti
J. Funct. Morphol. Kinesiol. 2017, 2(2), 12; https://doi.org/10.3390/jfmk2020012 - 19 Apr 2017
Cited by 7 | Viewed by 4486
Abstract
Cancer in humans is frequently associated with compartmentalization of body fluids as a result of sedentary behavior and pharmacological cellular toxicity. Total Body Water (TBW) in the general population is approximately 55–60% of body weight in adult males and 50–55% in adult females, [...] Read more.
Cancer in humans is frequently associated with compartmentalization of body fluids as a result of sedentary behavior and pharmacological cellular toxicity. Total Body Water (TBW) in the general population is approximately 55–60% of body weight in adult males and 50–55% in adult females, while varying significantly in pathological conditions. Exercise is largely recognized as an important tool to TBW distribution. The purpose of this study was to investigate, for a least 12 months, the impact of physical activity on body water distribution in a sample of cancer patients and compare their responses to a sample of healthy controls. Cancer patients included 28 clinically stable female cancer patients diagnosed with breast cancer (aged 59 ± 9 years, weight 70.2 ± 9.9 kg, and Body Mass Index (BMI 26.7 ± 5.4 kg·m2), who were enrolled in a year-long physical activity prescription program. The results indicated the absence of significant variations of TBW% between the cancer patients and controls, however, there was a significant improvement in intracellular water content (ICW%) at 6 months (T0: 51.1 ± 3.9 vs. T6: 52.4 ± 4.1; p < 0.05) and at T12 (T0: 51.1 ± 3.9 vs. T12: 53.6 ± 3.1; p < 0.005). In conclusion, in this small sample of cancer survivors, an unsupervised cancer rehabilitation program reduced the trend towards increased peripheral edema. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases 2017)
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Review

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Review
Physical Therapy Considerations for Chronic Kidney Disease and Secondary Sarcopenia
by Haniel J. Hernandez, Gideon Obamwonyi and Michael O. Harris-Love
J. Funct. Morphol. Kinesiol. 2018, 3(1), 5; https://doi.org/10.3390/jfmk3010005 - 05 Jan 2018
Cited by 12 | Viewed by 5458
Abstract
Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are [...] Read more.
Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are well-positioned among the health care team to screen for secondary sarcopenia in those with CKD and for the treatment of musculoskeletal comorbid conditions that may affect functional performance. Given the consequences of both low muscle mass and low bone mineral density, appropriate and timely physical therapy is important for fall risk assessment and intervention to minimize the susceptibility to bone fracture. While strength training has been studied less frequently than aerobic training for the management of secondary CKD conditions, evidence suggests that this patient population benefits from participation in strength training programs. However, the provision of a formal exercise prescription by a health care professional, along with formal implementation of an exercise program, may need to be more fully integrated into the standard plan of care for individuals with CKD. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases 2017)
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214 KiB  
Review
Exercise Training as Treatment of Nonalcoholic Fatty Liver Disease
by Oliver K. Glass, Akash Radia, William E. Kraus and Manal F. Abdelmalek
J. Funct. Morphol. Kinesiol. 2017, 2(4), 35; https://doi.org/10.3390/jfmk2040035 - 24 Sep 2017
Cited by 9 | Viewed by 5544
Abstract
Nonalcoholic Fatty Liver Disease (NAFLD) is a growing health epidemic in developed countries with increased prevalence in obese and diabetic populations. Exercise is an established and essential component of lifestyle modification for NAFLD disease management. Despite numerous studies reporting exercise-mediated improvements in NAFLD, [...] Read more.
Nonalcoholic Fatty Liver Disease (NAFLD) is a growing health epidemic in developed countries with increased prevalence in obese and diabetic populations. Exercise is an established and essential component of lifestyle modification for NAFLD disease management. Despite numerous studies reporting exercise-mediated improvements in NAFLD, there remains a large gap in our knowledge of how to optimize exercise prescriptions and whether the benefits of exercise extend beyond improvements in liver fat. In this review, we summarize studies that have investigated the independent effects of exercise training on liver enzymes, hepatic fat, and histologic markers in NAFLD. Overall, 12-weeks of aerobic, resistance, the combination of aerobic and resistance, and novel training modalities, including acceleration and hybrid training, significantly improve liver enzymes and hepatic fat. The greatest benefits in NAFLD may occur through the combination of aerobic and resistance training that targets both cardiorespiratory fitness, and mediators of skeletal muscle, known as myokines. Understanding the role of myokines in the beneficial effects of exercise in NAFLD may identify future therapeutic targets that can be modified with tailored exercise prescriptions. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases 2017)
190 KiB  
Review
Indications to Promote Physical Activity during Pregnancy
by Laura Stefani, Gabriele Mascherini and Giorgio Galanti
J. Funct. Morphol. Kinesiol. 2017, 2(3), 31; https://doi.org/10.3390/jfmk2030031 - 14 Aug 2017
Cited by 5 | Viewed by 3953
Abstract
Reduced physical activity in pregnancy is often associated with a progressive increase of chronic metabolic disease and to an enhanced risk for the child. The majority of women are less physically active during pregnancy, despite the motivation to improve their health, quality of [...] Read more.
Reduced physical activity in pregnancy is often associated with a progressive increase of chronic metabolic disease and to an enhanced risk for the child. The majority of women are less physically active during pregnancy, despite the motivation to improve their health, quality of life, and fitness. Education on the benefits of regular physical activity in pregnancy is determinant as suggested by obstetricians and gynecologists. The specific programs need to be supported by specialists in Sports Medicine. Counseling and support by nurses can also be helpful in encouraging women to maintain a sufficient level of physical activity during pregnancy or to modify their lifestyle, adapting the single models and specific physical activity programs to their needs. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases 2017)
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