初诊2型糖尿病患者出院6个月内自我管理行为的纵向调查

目的了解初诊2型糖尿病患者出院后6个月内自我管理行为的动态变化,为院外健康管理提供依据。方法运用自行设计的初诊2型糖尿病患者自我管理行为量表对115例初诊2型糖尿病患者出院后第1个月、第2个月、第3个月和第6个月的自我管理行为进行调查,分析不同时间点的自我管理行为差异。结果患者出院后第1个月、第2个月、第3个月的血糖监测、遵医用药维度和自我管理行为总分均逐渐降低,规律锻炼维度得分依次增加,差异有统计学意义(P0.05,P0.01)。结论随着出院时间的延长,初诊2型糖尿病患者自我管理能力逐渐减弱。前3个月为自我管理行为的可塑期,医护人员应采取有效措施加强随访,提高患者出院后的自我管理行为水平。     

运动对预防老年人跌倒效果的网状Meta分析

目的 系统评价运动对预防老年人跌倒的疗效.方法 检索1980年至2020年7月Web of Science、PubMed、Cochrane Library、中国知网数据库有关运动对预防老年人跌倒的随机对照试验,采用Review Manager 5.3对纳入文献进行质量评价,应用R-Studio和Addis 1.16.6...     

Balance exercise in patients with chronic sensory ataxic neuropathy: a pilot study

Although exercise therapy is considered part of the treatment of neuropathic patients, and somatosensory input is essential for motor learning, performance and neural plasticity, rehabilitation of patients with sensory ataxia has received little attention so far. The aim of this prospective pilot study was to explore the short‐ and medium‐term efficacy of a 3‐week intensive balance and treadmill exercise program in chronic ataxic neuropathy patients; 20 consecutive patients with leg overall disability sum score (ODSS‐leg) ≥2, absent/mild motor signs, clinical and therapeutic stability ≥4 months were enrolled. Evaluations were done at baseline, at the end of treatment and at 3‐ and 6‐month follow‐up. Outcome measurements included: ODSS‐leg, Berg balance scale, 6‐min walk distance, and the functional independence measure (FIM) scale. The short‐form‐36 health status scale (SF‐36) was used to measure health‐related quality of life (HRQoL). ODSS‐leg improved significantly compared with baseline, 3 weeks, 3 months (primary outcome), and 6 months follow‐up. A significant improvement in all functional secondary outcome measurements and in some SF‐36 subscales was also observed. This pilot study suggests that balance exercise is safe and well tolerated and might be effective in ameliorating disability and HRQoL in patients with chronic peripheral sensory ataxia.     

Low-intensity treadmill exercise and/or bright light promote neurogenesis in adult rat brain

The hippocampus is a brain region responsible for learning and memory functions. The purpose of this study was to investigate the effects of low-intensity exercise and bright light exposure on neurogenesis and brain-derived neurotrophic factor expression in adult rat hippocampus. Male Sprague-Dawley rats were randomly assigned to control, exercise, light, or exercise + light groups (n = 9 per group). The rats in the exercise group were subjected to treadmill exercise (5 days per week, 30 minutes per day, over a 4-week period), the light group rats were irradiated (5 days per week, 30 minutes per day, 10 000 lx, over a 4-week period), the exercise + light group rats were subjected to treadmill exercise in combination with bright light exposure, and the control group rats remained sedentary over a 4-week period. Compared with the control group, there was a significant increase in neurogenesis in the hippocampal dentate gyrus of rats in the exercise, light, and exercise + light groups. Moreover, the expression level of brain-derived neurotrophic factor in the rat hippocampal dentate gyrus was significantly higher in the exercise group and light group than that in the control group. Interestingly, there was no significant difference in brain-derived neurotrophic factor expression between the control group and exercise + light group. These results indicate that low-intensity treadmill exercise (first 5 minutes at a speed of 2 m/min, second 5 minutes at a speed of 5 m/min, and the last 20 minutes at a speed of 8 m/min) or bright-light exposure therapy induces positive biochemical changes in the brain. In view of these findings, we propose that moderate exercise or exposure to sunlight during childhood can be beneficial for neural development.     

Coactivation of the elbow antagonist muscles is not affected by the speed of movement in isokinetic exercise

Since muscle coactivation increases the stiffness and stability of a joint, greater coactivation is likely during faster than slower movements. Very few studies, though, have been conducted to verify this hypothesis. Moreover, a large number of studies have examined coactivation of muscles surrounding the knee joint whereas there are few reports on the elbow joint. The aim of this study was therefore to compare the antagonist activation of the elbow flexors and extensors during isokinetic concentric exercises and to investigate the influence of angular velocity on their activation. Twelve men participated in the study. The surface electromyographic signals (sEMG) were recorded from the biceps brachii (BB) and triceps brachii (TB) muscles during three maximal voluntary isometric contractions (MVC) of elbow flexors and extensors and a set of three maximal elbow flexions and extensions each at 15 degrees, 30 degrees , 60 degrees, 120 degrees, 180 degrees, and 240 degrees.s(-1). Normalized root mean square (RMS) of sEMG was calculated during the isokinetic phase of movement as an index of sEMG amplitude. During elbow flexion, the antagonist activation of BB averaged 16.2% lower than TB, and this difference was statistically significant at all angular velocities. The normalized RMS values ranged from 26.0% +/- 19.0 at MVC to 37.8% +/- 13.9 at 240 degrees.s(-1) for antagonist TB activation, and from 5.7% +/- 5.2 at MVC to 18.9% +/- 8.6 at 240 degrees.s(-1) for antagonist BB activation. No influence of angular velocity on agonist and antagonist activity was found. Moreover, flexion and extension torques were both strongly affected by the amount of antagonist activation. The functional specialization of the two muscle groups could be responsible for the different levels of antagonist activation. The frequent use of BB, which is not assisted by gravity during daily activities, could lead to reduced coactivation due to a better functioning of the control system based upon reciprocal innervation. These findings may have significant implications in the design of rehabilitation programs directed to the elbow joint.     

Improvement in Asthma Quality of Life in Patients Enrolled in a Prospective Study to Increase Lifestyle Physical Activity

Objective. Asthma patients know the benefits of exercise but often avoid physical activity because they are concerned that it will exacerbate asthma. The objective of this analysis was to assess longitudinal asthma status in 256 primary care patients in New York City enrolled in a trial to increase lifestyle physical activity. Methods. Patients were randomized to two protocols to increase physical activity during a period of 12 months. At enrollment, patients completed the Asthma Quality of Life Questionnaire (AQLQ) and the Asthma Control Questionnaire (ACQ) and received asthma self-management instruction through an evaluative test and workbook. Exercise and self-management were reinforced every 2 months. The AQLQ was repeated every 4 months and the ACQ was repeated at 12 months. Results. The mean age was 43 years and 75% were women. At 12 months there were clinically important increases in physical activity with no differences between groups; thus, data were pooled for asthma analyses. The enrollment AQLQ score was 5.0 ± 1.3 and increased to 5.9 ± 1.1 corresponding to a clinically important difference. Correlations between AQLQ and physical activity were approximately 0.35 (p < .0001) at each time point. In a mixed effects model, the variables associated with improvement in AQLQ scores over time were male sex, less severe asthma, not taking asthma maintenance medications, fewer depressive symptoms, and increased physical activity (all variables, p < .03). According to the ACQ, asthma was well controlled in 38% at enrollment and in 60% at 12 months (p < .0001). Conclusion. With attention to self-management, increased physical activity did not compromise asthma control and was associated with improved asthma.