Search Results (5,847)

Background/Objectives: Bone reconstruction using megaprostheses is increasingly performed following bone tumour resections, including sarcomas, to enhance patient outcomes and quality of life. However, this is a complex patient group, and there is little consensus as to postoperative rehabilitation and associated outcomes. Methods: A systematic search was conducted in MEDLINE and EMBASE databases according to the Implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidelines. Studies describing rehabilitation protocols and functional outcomes following bone tumour resection and modular oncologic megaprosthesis reconstruction were included. All papers were individually assessed for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tool. Results: The search generated 105 records, 28 underwent full-text review, and 13 studies were included. Available data reflect 371 patients with a mean age of 49.17 (S.D. 21.40) years and a mean postoperative follow-up of 41.88 (S.D. 32.88) months. Surgical indications were documented as sarcomas in 9 studies, and tumour metastasis to the bone in 10 studies. Rehabilitation protocols were reported in 5 studies following proximal humerus resection with a mean dislocation rate of 14.5% (S.D. 5.26). All protocols advised brace immobilisation for a period ranging between 10 days and 6 months. Superior Constant-Murley shoulder score was reported in patients with early active isometric exercises at 6 weeks. Six studies reported proximal femur prosthesis rehabilitation and functional outcomes, with a mean dislocation rate of 10% (S.D. 9.82). Enhanced outcomes were reported in studies employing early mobilisation. Two studies assessed distal femur prosthesis; both studies reported similar protocols with full weight bearing 3 weeks following surgery. The methodological quality of the studies varied, but was overall modest, with 10/13 studies meeting at least 50% of JBI reporting criteria. Conclusions: The existing literature on rehabilitation and outcomes in orthopaedic oncology patients following arthroplasty with megaprosthesis is limited, with rehabilitative protocols variably described. However, it seems that early active mobilisation does not increase the risk of joint dislocations or infections. Full article

The rate pressure product (RPP) is a non-invasive index of myocardial oxygen consumption, derived from heart rate (HR) and systolic blood pressure (SBP). While aerobic exercise is known to improve cardiovascular efficiency, evidence is limited for racialized populations, particularly African Canadians and South Asians who face elevated cardiovascular risk. Objective: The objective of the study was to examine whether a 10-session dance aerobics program provides a cardiovascular stimulus sufficient to affect RPP and blood pressure responses in these groups. Methods: A total of 160 participants with hypertension or related conditions (80 African Canadians, 80 South Asians) completed 10 sessions of community-based aerobic dance. Pre- and post-intervention measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP), HR, and RPP were obtained and analyzed using non-parametric statistical tests. Results: Both groups showed reductions in blood pressure after the intervention. South Asians demonstrated moderate decreases in SBP and RPP, while African Canadians exhibited stable or slightly increased RPP values despite improvements in SBP and DBP. Between-group comparisons showed significant differences in SBP and HR (p < 0.05), but changes in RPP did not reach statistical significance (p > 0.05). Despite the modest reductions in systolic BP (≥5 mmHg), this may carry clinical significance. Conclusion: This study highlights that blood pressure and RPP responses to exercise may differ across ethnic groups. Short-term dance aerobics effectively reduced blood pressure in both African Canadian and South Asian participants, supporting its role as a culturally adaptable intervention. These findings underline the importance of tailoring exercise recommendations to ethnic and cultural contexts and provide a case for larger studies in a multi-ethnic population. Full article

Background: Exercise is known to help with the effects of the menopause, but women from low socioeconomic status (SES) tend to exercise less at this stage of life. Therefore, this study aimed to investigate the physical and psychological effects of a Zumba Gold^® community-based intervention in postmenopausal women from low SES. Methods: Forty-three women were divided into a Zumba Gold^® (ZG) and control (C) group, and participated in pre- and post-testing sessions, separated by a 12-week intervention period. The outcomes measured were: body composition, sit-to-stand (STS), six-minute walk test (6MWT), balance, Short Form Health Survey (SF-12), Multidimensional Fatigue Index (MFI-20), Self-Efficacy for Exercise (SEE), Behavioral Regulations in Exercise (BREQ-2), Hospital Anxiety and Depression Scale (HADS), and Social Connectedness questionnaires. Semi-structured interviews were also performed on 15 ZG participants. Results: The results showed significant improvements in the ZG group only for STS, 6MWT, mental health, fatigue (general, physical, and mental), social connectedness score, and a significantly lower level of amotivation. Zumba Gold^® had positive effects on four main themes: belonging, non-judgmental place, psychological motivational factors, and mind–body connection. Conclusions:This is the first study to show that ZG is beneficial for this population and encourages similar studies on other aspects of the menopause. Full article

The circadian rhythm controls the sleep/wake cycle and a wide variety of metabolic and physiological functions. Clock genes regulate it in response to both external and endogenous stimuli, and their expression may change because of aging, leading to an increased risk of health problems. Despite the well-described benefits of physical exercise as a circadian synchronizer, there is a lack of literature regarding the role of chronic exercise intensity in clock gene expression during aging. This article aims to analyze the differential expression of genes that regulate the biological clock under the effects of variable-intensity aerobic swimming training in aging mice, determining whether these exercise regimens interfere with the genomic regulation of the circadian rhythm. For this purpose, the mice were exposed to low- and high-intensity exercise and had their heart and gastrocnemius tissues molecularly analyzed by cDNA synthesis and qPCR to determine the expression levels of the selected genes: Clock, Arntl, Per1, Per2, Cry1, Cry2, and Nr1d1. The results showed that low-intensity exercise, performed at workloads below the anaerobic threshold, significantly changed their expression in the gastrocnemius muscle (p < 0.05), while high-intensity exercise had no statistically significant effects (p > 0.05), with the heart being immune to exercise influence except when it comes to the Per1 gene, for which expression was increased (p = 0.031) by low-intensity exercise. Additionally, both body weight and lactate thresholds had no change during the experiment (p > 0.05), while the maximum supported workload was maintained for high-intensity exercise (p > 0.05) and increased for low-intensity exercise (p < 0.01), with the control group experiencing a decay instead (p < 0.05). Thus, the present study highlights the importance of chronic exercise in modulating clock genes and opens exciting possibilities for circadian medicine, such as improvements in exercise capacity, heart condition, and lipid metabolism for subjects of low-intensity regimens. Full article

Background: Fontan circulation is associated with impaired cardiac output, reduced exercise capacity, and systemic metabolic stress. However, the underlying lipidomic alterations remain poorly defined. Methods: Using targeted mass spectrometry, we analyzed 291 lipid species in fasting plasma samples from 20 adults with Fontan circulation and 20 age- and sex-matched healthy controls. Results: Forty-eight lipids were significantly altered between groups (p < 0.05), including reductions in total lysophosphatidylcholines (LPC) and total ether-linked LPC [LPC(O)] and elevations in total phosphatidylserines (PS). Notably, LPC(O-22:1) and LPC(O-20:0) were decreased, while PS 40:5 was elevated, with several of these species demonstrating strong correlations (|r| > 0.5, p < 0.001) with the stroke index, cardiac index, and VO₂max. These three lipid species also showed excellent capability in discriminating Fontan patients from healthy controls (AUC > 0.78). Correlation network and pathway enrichment analyses revealed tightly coordinated lipid clusters containing LPC/LPC(O), PE, and PS species as central features of dysregulated Fontan metabolism. Conclusions: These exploratory findings highlight coordinated lipid alterations associated with impaired cardiovascular reserve in Fontan patients. While based on unadjusted p-values and therefore being hypothesis-generating, they provide novel insight into the metabolic landscape of Fontan physiology and warrant validation in larger, independent cohorts. Full article

Objectives: Adolescence is a pivotal stage of development characterized by significant physical, psychological, and social changes. Establishing healthy lifestyle habits during this period is crucial for long-term health and the prevention of chronic diseases. Despite this, global trends show a marked decline in physical activity among adolescents, particularly girls, who are more susceptible to sedentary behaviors. One potential site for intervention to eliminate physical inactivity at the population level is the school educational setting during childhood. Traditional school-based physical exercise programs often adopt a one-size-fits-all approach, which may not address the diverse needs and interests of students, leading to reduced motivation and participation. Personalized physical exercise programs, tailored to individual capabilities and preferences, offer a promising alternative to enhance physical fitness and foster lifelong engagement in physical activity. Methods: A total of 170 Hungarian high school girls (mean age ≈ 15.3 years) were randomly assigned to either a personalized physical exercise group or a control group following the standard curriculum. The intervention spanned two academic years and consisted of five traditional gym classes per week (control group) or three traditional and two individually tailored classes with cardiorespiratory and resistance training per week (intervention group), each lasting 45–60 min. Individual goals were set based on baseline assessments, emphasizing self-referenced progress. Results: The personalized physical exercise group showed significant improvements in body mass index (BMI), body fat percentage, maximum oxygen uptake capacity (VO₂max), muscular strength, and flexibility (p < 0.05), while the control group exhibited minimal or negative changes. Conclusions: The personalized physical exercise program has been shown to be more effective in achieving higher cardiorespiratory performance and favorable body composition among adolescent girls than a traditional school physical education class, highlighting its potential role in school settings. Full article

Background: Glucose intolerance (GI) is a metabolic disorder that is a consequence of hyperglycemia. Glucose intolerance can, under some conditions, progress to type 2 diabetes mellitus (T2D), where insulin is insufficiently utilized. As a result of genetic and lifestyle effects, the incidence of T2D has increased worldwide. Pathophysiological consequences of the disease may include retinopathy, nephropathy, and neuropathy. Skeletal muscle is one of the major organs that regulates blood sugar homeostasis, both at rest and during exercise. Thus, understanding the molecular and genetic perspectives on the contribution of skeletal muscles to the predisposition to diabetes is a hot topic in diabetes research. In this study, we conducted a differential analysis of gene expression and compared the expression profiles of all the genes in the skeletal muscles of normal, glucose-intolerant, and diabetic individuals via the Affymetrix HGU133plus2 platform. Data were collected from the Gene-Expression Omnibus (GEO) series GSE18732. Gene Ontology enrichment and perturbed pathways were thoroughly analyzed. Results: We found that genes that were significantly differentially expressed between the different tissues contribute to metabolic pathways related to glucose homeostasis, as well as several signaling pathways related to insulin signaling, e.g., the MAPK, mTOR, Toll-like receptor (TLR), p53, WNT and neurotrophin signaling pathways. Furthermore, some genes related to several malignancies were also differentially expressed across the different clinical groups. Additionally, some of these genes are related to epigenetic regulation. Furthermore, other differentially expressed genes were connected to several myopathies. Conclusions: This study may serve as a gene-based analysis that contributes as a basis for further analysis. This investigation may include gene and protein networks that serve in understanding diabetes, the mechanism of action of the involved proteins, and pharmacology and drug design targeting T2D. Full article

Background/Objectives: Tendinopathies represent a prevalent musculoskeletal condition characterized by load-dependent pain, stiffness, weakness, and impaired functionality. Current treatment includes therapeutic exercise, physical modalities and injective therapy. Hyaluronic acid (HA) is a fundamental component of the extracellular matrix and plays a crucial role in tissue hydration, elasticity, and lubrication. This study aims to evaluate the effectiveness of ultrasound-guided injections of HA in improving pain symptoms and functionality in patients with supraspinatus tendinopathy. Methods: Patients with a confirmed diagnosis of supraspinatus tendinopathy, verified through ultrasound imaging, were included in the study. Patients underwent 3 ultrasound guidance injections (1/week) of Sodium Hyaluronate (Hyalotend, 20 mg/2 mL). Patients were evaluated at the baseline, 1 month (T1), 3 months (T2), 6 months (T3), and 1 year (T4) after the first injection through the VAS, the QuickDASH and the SF-12. Results: Twenty-four patients were enrolled. As regards the VAS there was a statistically significant reduction (p < 0.01) of averages of values over time. The scores collected through the QuickDASH questionnaire have a statistically significant variation over time (p < 0.001). The values collected through the SF-12 Mental Component Summary (MCS) questionnaire show a highly statistically significant variation over time (p < 0.005). The values collected through the SF-12 Physical Component Summary (PCS) questionnaire show a statistically highly significant change over time (p < 0.001). Conclusions: Our results suggest that HA (Hyalotend) injections could represent a viable therapeutic option for patients with supraspinatus tendinopathy in the short, medium, and long term. Further studies with larger patient samples and a control group are needed to better investigate the effects and the modalities of administration of HA in tendinopathies. Full article

This study aimed to evaluate the effects of jump rope training on cardiovascular capacity, assessed with the Ruffier test, and muscular strength, measured using isometric dynamometry (BioFET Mustec, Almere, The Netherlands), within a university physical education program. A total of 52 undergraduate students from non-specialist faculties at the University of Oradea were randomly assigned to either an experimental group (EG) or a control group (CG). Over eight weeks, the EG performed a ten-minute jump rope training session once per week in combination with cardiovascular exercises, while the CG participated only in cardiovascular exercises. Statistical analyses revealed a significant group effect on cardiovascular response (Ruffier Index: p = 0.019; Cohen’s d = −0.271) and a substantial increase in right lower limb strength (p = 0.003; d = 1.026) in the EG compared to the CG. Furthermore, improvements were observed in upper limb strength (left arm: p = 0.010; d = 0.922) and left lower limb strength (p = 0.027; d = 0.779). These findings suggest that incorporating jump rope training into university physical education classes may represent an effective and low-cost strategy to enhance both cardiovascular efficiency and muscular strength in young adults. Given its simplicity and affordability, jump rope training appears feasible for implementation in schools and universities, even where resources are limited. Future research should investigate its long-term effects across different populations. Full article

Background: Osteoarthritis has a large and growing burden in an ageing population. Controversy exists in current management, particularly regarding opioid use due to increasing negative effects. Clinicians need guidance on the individual mortality associations for common osteoarthritis treatments when compared to a control. Aims: The aim is to undertake a structured narrative literature review comparing mortality associations for common osteoarthritis management options. Methods: A search strategy (Web of Science 23 September 2024) was performed to identify observational studies which reported all-cause mortality in a treatment group compared to a control. The control group could be either the general population or those with osteoarthritis who were treated with the following: NSAIDs (non-steroidal anti-inflammatory drugs), opioids, paracetamol, GLP-1 RAs (Glucagon-like peptide-1 receptor agonists), hip or knee arthroplasty, or exercise. Articles were screened by two authors, and each included article was assessed for adequate quality using the strengthening the reporting of observational studies in epidemiology (STROBE) framework. Results: Of 2362 studies retrieved, 39 cohort studies met the inclusion requirements. Exercise, compared to no or lower levels of exercise, had ten studies reporting substantially reduced all-cause mortality. GLP-1 RA agonists had two related studies showing all-cause mortality reduction up to 5 years. Mortality following joint arthroplasty followed a multi-phasic response. There was a short-term post-surgical increase in mortality. However, from 90 days post-surgery to 8–11 years, there were significant reductions in mortality. After 9–12 years post arthroplasty, mortality increased and became significantly higher. Opioids were associated with an increase in mortality in 6 out of 7 studies. Inconsistent trends were found for NSAIDs and paracetamol. Conclusions: Exercise and GLP-1 RA prescription are associated with reduced all-cause mortality. Arthroplasty was found to have survival benefit until 9–11 years post-operatively, whereafter mortality then increased. Opioids were found to consistently increase mortality when used for non-cancer pain at all time points. The other common osteoarthritis treatments assessed were not consistently associated with changes in mortality. Full article

Background: Unhealthy lifestyles have been reported among university students, characterized by excess body weight and physical inactivity, which affects body composition and increases the risk of non-communicable diseases. Physical exercise (PE) is an effective strategy for body reshaping; however, its demands and difficulties make its practice complex. Therefore, there was an interest in investigating the effects of a low-volume, moderate-intensity interval training (MIIT) protocol. Methods: A 5-week quasi-experimental study was conducted. Twelve university students (ten women and two men), aged 22 ± 3.4 years, engaged in low-level physical activity. The intervention group (n = 6) performed a MIIT protocol of 1′ × 1′ × 7′ (seven series of 1 min of moderate-intensity exercise interleaved with a recovery period of 1 min) three times a week, while the control group (n = 6) continued with its regular activities. Results: Significant improvements were reported in body fat percentage (%BF) (p = 0.04; d = 0.9), fat mass (FM) (p = 0.00; d = 0.7) and recovery heart rate (RHR) (p = 0.001); d = 1) in the MIIT group compared with the pre-test and control group values. Furthermore, the body weight (p = 0.04) and body mass index (BMI) (p = 0.04) values also improved in the MIIT group, compared to the pre-test values. Conclusions: MIIT is an effective strategy for short-term improvement in body composition, as well as in anthropometric measures and fitness parameters, in university students with a low PAL. Its ease of applicability—based on low exercise volume and intensity—is notable, making it feasible of incorporation into student health programs. Full article

Background/Objectives: Vitamin D deficiency is a global epidemic. In certain populations, such as the United Arab Emirates (UAE), low nutritional intake of vitamin D, inadequate exposure to sunlight, and cultural dress codes can lead to deficiencies in blood vitamin D levels, predisposing them to musculoskeletal disorders, diabetes, and cardiovascular diseases. There are also notable associations between vitamin D deficiency, physical inactivity, and lower cognitive performance. The aim of this study was to determine how vitamin D status may affect physical inactivity and cognitive performance in a young UAE population. Methods: Primary data were obtained on vitamin D status, cardiorespiratory fitness, body composition, and blood profiles of students in the UAE. Following initial assessment, a cohort of vitamin D-deficient/insufficient individuals participated in a 10-week physical activity intervention (Group A), whilst another cohort was supplemented with 5000 IU vitamin D3 daily and an exercise intervention (Group B). Both groups underwent physiological and biochemical profiling, and the effects of vitamin D supplementation on cognitive function were assessed. Statistical analysis included paired samples t-tests between pre- and post-intervention values and the Wilcoxon signed rank test for within-group comparisons and the Mann–Whitney U test for between-group comparisons. Results: The findings suggest that physical exercise alone improves overall cardiorespiratory fitness, as shown by an increased VO₂ max (p < 0.05), while vitamin D supplementation combined with physical exercise did not significantly improve fitness over a 10-week period (p > 0.05). However, vitamin D combined with physical exercise significantly improved cognitive performance in Group B only, specifically in working memory, verbal memory, and cognitive flexibility (p < 0.05). Conclusions: This study highlights the need for targeted interventions such as physical exercise and vitamin D supplementation to be conducted at an early stage in order to improve physical and cognitive function and reduce the risk of disease. Full article

Long COVID is characterized by persistent symptoms associated with chronic inflammation and oxidative stress. While high-intensity interval training (HIIT) and supplementation with antioxidants such as Triphala have demonstrated individual therapeutic benefits, their combined effects remain unclear. This study aimed primarily to evaluate the effects of an 8-week HIIT program on markers of inflammation, oxidative stress, and exercise-related symptoms in individuals with long COVID, and secondarily to explore whether Triphala supplementation provided additional benefits. A total of 104 participants (aged 18–59 years) were randomized into three groups—control (placebo), HIIT (cycling for 28 min/day, 3 days/week), and combined (HIIT + Triphala, 1000 mg/day)—for 8 weeks. The biomarkers assessed included interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), protein carbonyls, and superoxide dismutase (SOD) activity. Following the intervention, significant reductions in IFN-γ, TNF-α, MDA, protein carbonyls, and rating of perceived exertion were observed in both the HIIT and combined groups (p < 0.05), with no significant differences between the two. SOD activity significantly increased in all groups, including the control group (p < 0.05), with no between-group differences. An 8-week HIIT program appears to be effective in reducing inflammation, oxidative stress, and dyspnea in individuals with long COVID. Triphala supplementation did not provide any additional statistically significant benefit but was safe and well tolerated. Full article

Background: Cancer has a high mortality rate and leaves physical and mental difficulties even after treatment. When it afflicts frail elderly people, it poses a greater burden to them and society. Regular exercise helps to restore the deteriorated health of cancer survivors. The purpose of this study was to compare the effects of a short-term, high-repetition, home-based “exercise snack” program with those of a traditional, continuous, moderate-intensity exercise format on key health outcomes in elderly cancer survivors, including quality of life, cardiorespiratory fitness, and metabolic flexibility. Methods: A short-duration, high-repetition exercise snack group (ESG, n = 17) and a traditional exercise group (TEG, n = 17) were compared after 12 weeks of training. The effects of exercise on quality of life, cardiorespiratory fitness, metabolic flexibility, and blood lipids were measured. Results: Quality-of-life vitality, social functioning, cardiorespiratory fitness VO₂ peak, and high-density lipoprotein cholesterol were improved more in ESG than in TEG (p < 0.05). Metabolic flexibility showed that fat utilization increased and carbohydrate utilization decreased post-training compared to pre-training at VO₂ peak 20 and 40% in both groups (p < 0.05). Conclusions: In both groups, cardiorespiratory fitness was shown along with physical and psychological improvements in quality of life, and the efficiency of metabolic flexibility was also improved. Therefore, short-term, frequent exercise may be an appropriate exercise alternative for elderly people with difficulties. Full article

Background: Therapeutic exercise (TE) is recommended as the first line of treatment for low back pain (LBP), but questions remain about the true efficacy of TE in the acute phase. This study aimed to evaluate the effectiveness of isolated TE in reducing pain intensity and disability in patients with acute or subacute LBP. Methods: A systematic review with meta-analysis was conducted following the PRISMA guidelines. Randomized controlled trials (RCTs) that analyzed therapeutic exercise alone in one of the intervention groups and assessed pain intensity and disability were included; both outcomes were considered primary in this review. The quality of evidence was assessed using the GRADE tool. Results: Five RCTs were included. Meta-analyses were performed in subgroups according to the comparators: usual care, education, manual therapy, and bed rest. Statistically significant differences in favor of TE were found only when compared to usual care (SMD = −0.23; 95% CI [−0.45, −0.01]; p = 0.04). Conclusions: TE, when prescribed as an isolated intervention, appears to be more effective than usual care in improving short-term disability outcomes in patients with acute LBP. However, the limited quality and number of available studies, together with the typically favorable natural course of acute LBP, suggest that these findings should be interpreted with caution. Current evidence supports the integration of exercise within a comprehensive, multimodal management plan that addresses the physical, psychological, and social dimensions of pain. Full article