The biomechanics of sitting-acquired pressure ulcers in patients with spinal cord injury or lesions

Sitting-acquired pressure ulcers (SAPU) in permanent wheelchair users with traumatic or non traumatic disorders of the central nervous system (CNS) are a great medical challenge. The purpose of this review is to summarise what is currently known concerning the aetiology of SAPU, particularly in its severe form, which may now be classified as a 'deep tissue injury' according to the US National Pressure Ulcer Advisory Panel. Specifically, this review focuses on biomechanical aspects of deep SAPU and describes the relevant bioengineering methodologies and research evidence. It discusses the unique biomechanical conditions in deep tissues, which are caused by chronic sitting associated with CNS disorders, and overall, the present review indicates that avoiding interface pressures above 32 mmHg in such patients is not necessarily a 'pressure relief.'     

Working from home during the COVID-19 pandemic and its longitudinal association with physical activity and sedentary behavior

ObjectiveWorking from home during the COVID-19 pandemic has affected many workers’ daily life and possibly their physical activity behavior. We studied the longitudinal association of working from home during the pandemic with physical activity and sedentary behavior.MethodsLongitudinal data from 17 questionnaire rounds of the Lifelines COVID-19 cohort (March 2020–February 2021) were used. In total, 33 325 workers were included. In every round, participants reported their current work situation: location, home, or hybrid (working on location and from home). Physical activity levels and sedentary behavior before and during the pandemic were asked. Logistic generalized estimating equations adjusted for demographic/work/health covariates were used to study the association of work situation with physical activity and sedentary behavior.ResultsHome workers were less likely to meet the recommended ≥150 minutes/week of moderate-to-vigorous-intensity activity during the pandemic than location workers [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.90–0.96] and more likely to be less physically active than before the pandemic (OR 1.09, 95% CI 1.04–1.14). Furthermore, compared to location workers, home and hybrid workers were more likely to be more sedentary (sitting ≥8 hours/day) on workdays during than before the pandemic (OR 1.51, 95% CI 1.39–1.64/1.36–1.68, respectively).ConclusionsCompared to location workers, home workers (and to a lesser extent hybrid workers) were more often physically inactive and sedentary during than before the COVID-19 pandemic. As a substantial part of the working population may continue to work (partly) from home after the pandemic, workers should be supported to increase activity and reduce sitting while working from home.     

辅助坐站转移训练对重度脑瘫儿童运动功能的影响

目的：探讨辅助坐站转移训练对重度脑性瘫痪儿童运动功能的影响,为改善重度脑瘫儿童的运动功能提供临床依据。方法：纳入重度脑瘫儿童30例,按照随机数字表法分为研究组和对照组,每组15例。对照组采用目标导向性训练 (GDT),研究组在GDT的基础上加用辅助坐站转移训练。治疗前及治疗1个月、3个月时对2组儿童进行粗大运动功能量表88项评估（GMFM-88）中的仰卧位与俯卧位（A区）和坐位（B区）、精细功能评估（FMFM）中视觉追踪（A区）和上肢关节活动（B区）和坐位能力（LSS）进行评估;比较2组儿童治疗前及治疗1个月、3个月后GMFM-88（A区与B区）、FMFM（A区与B区）及LSS评分的差异性。结果：2组患儿GMFM-A区、GMFM-B区、FMFM-A区、FMFM-B区及LSS评分结果显示组别与时间存在交互作用（F=158.406、326.724、462.387、698.547、177.029,均P<0.01）。治疗１个月及３个月后,2组的GMFM-A区、GMFM- B区、FMFM-A区、FMFM-B区及LSS评分均高于治疗前评分（P<0.05）。治疗1个月后,研究组LSS评分高于对照组（P<0.05）;2照组在GMFM-88中A区与B区评分和FMFM中A区与B区评分的差异均无统计学意义。治疗3个月后,研究组的各项评分均高于对照组（P<0.05）。结论：辅助坐站转移训练可以提高重度脑性瘫痪儿童的粗大运动功能、坐位能力及精细运动功能。     

坐式八段锦功法锻炼治疗老年男性骨质疏松症所致下腰痛临床研究

目的:观察坐式八段锦功法锻炼治疗老年男性骨质疏松症(OP)所致下腰痛的临床疗效.方法:将70例OP所致下腰痛老年男性患者按随机数字表法分为治疗组和对照组各35例.经过为期6个月的治疗及随访,部分患者因失访、治疗依从性较差、八段锦功法练习欠规律等原因剔除,最终纳入研究43例.对照组25例,给予优化生活方式、补充钙剂、维生...     

Dose-response effects of periodic physical activity breaks on the chronic inflammatory risk associated with sedentary behavior in high- and upper-middle income countries: A systematic review and meta-analysis

Background and aimsThough moderate-vigorous physical activity (MVPA) is speculated to mitigate the inflammatory risk associated with sedentary behavior, only a fraction of the global population meets the recommended weekly dose of MVPA. More individuals indulge in bouted and sporadic light-intensity physical activity (LIPA) that occurs throughout the typical day. However, the anti-inflammatory effects of LIPA or MVPA breaks during prolonged sitting remains unclear.MethodsA systematic search was done on six peer-reviewed databases through January 27th, 2023. Two authors independently screened the citations for eligibility, and risk of bias and performed a meta-analysis.ResultsThe included studies originated from high and upper – middle income countries. Observational studies of SB interruptions with LIPA showed favourable effects on inflammatory mediators such as higher levels of adiponectin (odds ratio, OR = +0.14; p = 0.02). However, these findings are not supported by the experimental studies. Experimental studies reported non-significant increase in cytokines including IL-1β (standardised mean difference, SMD = 0.11 pg/ml; p = 0.29) and IL-6 (SMD = 0.19 pg/ml; p = 0.46) after interrupting sitting with LIPA breaks. But these LIPA breaks were found to reduce C-reactive protein (SMD = - 0.50 mg/dl; p = 0.85) and IL-8 levels (SMD = ?0.08 pg/ml; p = 0.34) but did not reach statistical significance.ConclusionInterrupting prolonged sitting time with LIPA breaks shows promise for preventing the inflammatory effects associated with prolonged bouts of daily sitting, though the evidence remains in infancy and limited to high- and upper-middle income countries.     

不同体位摄食训练对喉癌术后患者康复效果的影响

目的 评价不同体位摄食训练对喉癌术后患者康复效果的影响。 方法 采取便利抽样法抽取符合纳入标准的喉癌术后患者108例，根据随机数字表法将患者分为对照组、试验1组、试验2组各36例，术后指导三组患者分别采取床头抬高90°直立坐位、床头抬高60°仰卧位、床头抬高30°仰卧位进行摄食训练，并对三组吞咽安全性、吞咽功能、自我效能感及食物剩余量进行评价。 结果 摄食训练1周，试验2组吞咽安全性受损程度、自我效能感得分及进食量显著优于试验1组和对照组（均P＜0.05），三组吞咽功能恢复情况比较，差异无统计学意义（P＞0.05）。 结论 对喉癌术后患者采取床头抬高30°仰卧位进行摄食训练，可减少患者吞咽安全性受损，提高患者自我效能感及进食量，以满足患者营养供给。     

改良八式坐式太极拳对化疗期间肺癌患者健康相关生活质量的研究

目的:观察改良八式坐式太极拳对化疗期间肺癌患者健康相关生活质量的影响.方法:59例患者分成干预组29例和对照组30例,对照组患者接受化疗科常规治疗,干预组在常规治疗的基础上,由康复治疗师指导,增加八式坐式太极拳训练,化疗期间每日一次,每次20～30min.分别于治疗前、治疗6周和12周末采用欧洲癌症研究治疗组织生活质量...     

Physical activity and sedentary behavior show distinct associations with tissue-specific insulin sensitivity in adults with overweight

Aim

The aim of this study is to investigate associations between the physical activity (PA) spectrum (sedentary behavior to exercise) and tissue-specific insulin resistance (IR).

Methods

We included 219 participants for analysis (median [IQR]: 61 [55; 67] years, BMI 29.6 [26.9; 32.0] kg/m²; 60% female) with predominant muscle or liver IR, as determined using a 7-point oral glucose tolerance test (OGTT). PA and sedentary behavior were measured objectively (ActivPAL) across 7 days. Context-specific PA was assessed with the Baecke questionnaire. Multiple linear regression models (adjustments include age, sex, BMI, site, season, retirement, and dietary intake) were used to determine associations between the PA spectrum and hepatic insulin resistance index (HIRI), muscle insulin sensitivity index (MISI) and whole-body IR (HOMA-IR, Matsuda index).

Results

In fully adjusted models, objectively measured total PA (standardized regression coefficient β = 0.17, p = 0.020), light-intensity PA (β = 0.15, p = 0.045) and moderate-to-vigorous intensity PA (β = 0.13, p = 0.048) were independently associated with Matsuda index, but not HOMA-IR (p > 0.05). A higher questionnaire-derived sport index and leisure index were associated with significantly lower whole-body IR (Matsuda, HOMA-IR) in men but not in women. Results varied across tissues: more time spent sedentary (β = −0.24, p = 0.045) and a higher leisure index (β = 0.14, p = 0.034) were respectively negatively and positively associated with MISI, but not HIRI. A higher sport index was associated with lower HIRI (β = −0.30, p = 0.007, in men only).

Conclusion

While we confirm a beneficial association between PA and whole-body IR, our findings indicate that associations between the PA spectrum and IR seem distinct depending on the primary site of insulin resistance (muscle or liver).