scholarly journals Do Diet and Lifestyles Play a Role in the Pathogenesis of NMSCs?

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3459
Author(s):  
Nevena Skroza ◽  
Ilaria Proietti ◽  
Anna Marchesiello ◽  
Salvatore Volpe ◽  
Veronica Balduzzi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Protective Factor ◽  
Statistical Significance ◽  
Control Group ◽  
Modifiable Risk Factors ◽  
Face To Face ◽  
Skin Cancers ◽  
Reduced Physical Activity ◽  
Cancer Types

Background and Aims: Literature highlights the role of risk factors like age, body mass index (BMI), tobacco smoking, alcohol intake and diet in the pathogenesis of several cancer types but little is known for non-melanoma skin cancers (NMSC). The aim of this epidemiological study was to evaluate the correlation between modifiable risk factors (BMI, metabolic panel, diet, lifestyle, medical history) and not modifiable risk factors (gender, age) and NMSC development. Methods: From February 2018 to September 2019, 162 patients affected by NMSC were compared to a group of 167 controls. A univariate and multivariate analysis was conducted to elaborate the data collected through face-to-face interviews. Results: While our evidence did not always reach statistical significance, NMSC study group patients exhibited high rates of analyzed risk factors (male gender aging over 55 years, high BMI, reduced physical activity) compared to the control group. Conclusions: Our study indicates that practicing more than 30 min of physical activity daily could be a protective factor against the NMSC onset. Other risk factors were not correlated with NMSC, but more evidence is needed to establish a possible link.

scholarly journals Effectiveness of Individual Real-Time Video Counseling on Smoking, Nutrition, Alcohol, Physical Activity, and Obesity Health Risks: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Judith Byaruhanga ◽  
Prince Atorkey ◽  
Matthew McLaughlin ◽  
Alison Brown ◽  
Emma Byrnes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Systematic Review ◽  
Alcohol Consumption ◽  
Real Time ◽  
Telephone Counseling ◽  
Video Communication ◽  
Control Group ◽  
Face To Face ◽  
Counseling Group

BACKGROUND Real-time video communication technology allows virtual face-to-face interactions between the provider and the user, and can be used to modify risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. No systematic reviews have examined the effectiveness of individual real-time video counseling for addressing each of the risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. OBJECTIVE This systematic review aims to examine the effectiveness of individually delivered real-time video counseling on risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. METHODS The MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica Database), PsycINFO, Cochrane Register of Controlled Trials, and Scopus databases were searched for eligible studies published up to November 21, 2019. Eligible studies were randomized or cluster randomized trials that tested the effectiveness of individual real-time video communication interventions on smoking, nutrition, alcohol, physical activity, and obesity in any population or setting; the comparator was a no-intervention control group or any other mode of support (eg, telephone); and an English-language publication. RESULTS A total of 13 studies were eligible. Four studies targeted smoking, 3 alcohol, 3 physical activity, and 3 obesity. In 2 of the physical activity studies, real-time video counseling was found to significantly increase physical activity when compared with usual care at week 9 and after 5 years. Two obesity studies found a significant change in BMI between a video counseling and a documents group, with significantly greater weight loss in the video counseling group than the in-person as well as the control groups. One study found that those in the video counseling group were significantly more likely than those in the telephone counseling group to achieve smoking cessation. The remaining studies found no significant differences between video counseling and telephone counseling or face-to-face counseling for smoking cessation, video counseling and face-to-face treatment on alcohol consumption, video counseling and no counseling for physical activity, and video counseling and face-to-face treatment on BMI. The global methodological quality rating was moderate in 1 physical activity study, whereas 12 studies had a weak global rating. CONCLUSIONS Video counseling is potentially more effective than a control group or other modes of support in addressing physical inactivity and obesity and is not less effective in modifying smoking and alcohol consumption. Further research is required to determine the relative benefits of video counseling in terms of other policy and practice decision-making factors such as costs and feasibility.

scholarly journals Effectiveness of Individual Real-Time Video Counseling on Smoking, Nutrition, Alcohol, Physical Activity, and Obesity Health Risks: Systematic Review

10.2196/18621 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e18621 ◽  
Author(s):  
Judith Byaruhanga ◽  
Prince Atorkey ◽  
Matthew McLaughlin ◽  
Alison Brown ◽  
Emma Byrnes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Systematic Review ◽  
Alcohol Consumption ◽  
Real Time ◽  
Telephone Counseling ◽  
Video Communication ◽  
Control Group ◽  
Face To Face ◽  
Counseling Group

Background Real-time video communication technology allows virtual face-to-face interactions between the provider and the user, and can be used to modify risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. No systematic reviews have examined the effectiveness of individual real-time video counseling for addressing each of the risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. Objective This systematic review aims to examine the effectiveness of individually delivered real-time video counseling on risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. Methods The MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica Database), PsycINFO, Cochrane Register of Controlled Trials, and Scopus databases were searched for eligible studies published up to November 21, 2019. Eligible studies were randomized or cluster randomized trials that tested the effectiveness of individual real-time video communication interventions on smoking, nutrition, alcohol, physical activity, and obesity in any population or setting; the comparator was a no-intervention control group or any other mode of support (eg, telephone); and an English-language publication. Results A total of 13 studies were eligible. Four studies targeted smoking, 3 alcohol, 3 physical activity, and 3 obesity. In 2 of the physical activity studies, real-time video counseling was found to significantly increase physical activity when compared with usual care at week 9 and after 5 years. Two obesity studies found a significant change in BMI between a video counseling and a documents group, with significantly greater weight loss in the video counseling group than the in-person as well as the control groups. One study found that those in the video counseling group were significantly more likely than those in the telephone counseling group to achieve smoking cessation. The remaining studies found no significant differences between video counseling and telephone counseling or face-to-face counseling for smoking cessation, video counseling and face-to-face treatment on alcohol consumption, video counseling and no counseling for physical activity, and video counseling and face-to-face treatment on BMI. The global methodological quality rating was moderate in 1 physical activity study, whereas 12 studies had a weak global rating. Conclusions Video counseling is potentially more effective than a control group or other modes of support in addressing physical inactivity and obesity and is not less effective in modifying smoking and alcohol consumption. Further research is required to determine the relative benefits of video counseling in terms of other policy and practice decision-making factors such as costs and feasibility.

Correlation of Metabolic Risk Factors with Sessile Serrated Lesions

2020 ◽  
Vol 29 (2) ◽  
pp. 175-179
Author(s):  
Melania Macarie ◽  
Simona Bataga ◽  
Simona Mocan ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Statistical Significance ◽  
Interval Cancer ◽  
Metabolic Risk Factors ◽  
Control Group ◽  
Anatomical Site ◽  
Metabolic Risk ◽  
Right Colon ◽  
Serrated Lesions ◽  
The Right

Background and Aims: The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called “interval cancer”, having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions. Methods: We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps’ development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease. Results: For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance. Conclusions: Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.

scholarly journals Epidemiology, Risk Factors, and Outcomes of Opportunistic Infections after Kidney Allograft Transplantation in the Era of Modern Immunosuppression: A Monocentric Cohort Study

2019 ◽  
Vol 8 (5) ◽  
pp. 594 ◽  
Author(s):  
Philippe Attias ◽  
Giovanna Melica ◽  
David Boutboul ◽  
Nathalie De Castro ◽  
Vincent Audard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factor ◽  
Opportunistic Infections ◽  
Control Group ◽  
Kidney Allograft ◽  
Extended Criteria Donor ◽  
Allograft Transplantation ◽  
Kidney Recipients ◽  
Independent Risk Factors ◽  
Kidney Transplantations

Epidemiology of opportunistic infections (OI) after kidney allograft transplantation in the modern era of immunosuppression and the use of OI prevention strategies are poorly described. We retrospectively analyzed a single-center cohort on kidney allograft adult recipients transplanted between January 2008 and December 2013. The control group included all kidney recipients transplanted in the same period, but with no OI. We analyzed 538 kidney transplantations (538 patients). The proportion of OI was 15% (80 and 72 patients). OI occurred 12.8 (6.0–31.2) months after transplantation. Viruses were the leading cause (n = 54, (10%)), followed by fungal (n = 15 (3%)), parasitic (n = 6 (1%)), and bacterial (n = 5 (0.9%)) infections. Independent risk factors for OI were extended criteria donor (2.53 (1.48–4.31), p = 0.0007) and BK viremia (6.38 (3.62–11.23), p < 0.0001). High blood lymphocyte count at the time of transplantation was an independent protective factor (0.60 (0.38–0.94), p = 0.026). OI was an independent risk factor for allograft loss (2.53 (1.29–4.95), p = 0.007) but not for patient survival. Post-kidney transplantation OIs were mostly viral and occurred beyond one year after transplantation. Pre-transplantation lymphopenia and extended criteria donor are independent risk factors for OI, unlike induction therapy, hence the need to adjust immunosuppressive regimens to such transplant candidates.

scholarly journals Modifiable and Non-Modifiable Risk Factors for Atherothrombotic Ischemic Stroke among Subjects in the Malmö Diet and Cancer Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1952
Author(s):  
Anna Johansson ◽  
Isabel Drake ◽  
Gunnar Engström ◽  
Stefan Acosta
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Body Mass Index ◽  
Ischemic Stroke ◽  
Family History ◽  
Diet Quality ◽  
Alcohol Intake ◽  
Modifiable Risk Factors ◽  
History Of ◽  
Diet And Cancer

Risk factors for ischemic stroke is suggested to differ by etiologic subtypes. The purpose of this study was to examine the associations between modifiable and non-modifiable risk factors and atherothrombotic stroke (i.e., excluding cardioembolic stroke), and to examine if the potential benefit of modifiable lifestyle factors differs among subjects with and without predisposing comorbidities. After a median follow-up of 21.2 years, 2339 individuals were diagnosed with atherothrombotic stroke out of 26,547 study participants from the Malmö Diet and Cancer study. Using multivariable Cox regression, we examined non-modifiable (demographics and family history of stroke), semi-modifiable comorbidities (hypertension, dyslipidemia, diabetes mellitus and atherosclerotic disease), and modifiable (smoking, body mass index, diet quality, physical activity, and alcohol intake) risk factors in relation to atherothrombotic stroke. Higher age, male gender, family history of stroke, and low educational level increased the risk of atherothrombotic stroke as did predisposing comorbidities. Non-smoking (hazard ratio (HR) = 0.62, 95% confidence interval (CI) 0.56–0.68), high diet quality (HR = 0.83, 95% CI 0.72–0.97) and high leisure-time physical activity (HR = 0.89, 95% CI 0.80–0.98) decreased the risk of atherothrombotic ischemic stroke independent of established risk factors, with non-significant associations with body mass index and alcohol intake. The effect of the lifestyle factors was independent of predisposing comorbidities at baseline. The adverse effects of several cardiovascular risk factors were confirmed in this study of atherothrombotic stroke. Smoking cessation, improving diet quality and increasing physical activity level is likely to lower risk of atherothrombotic stroke in the general population as well as in patient groups at high risk.

scholarly journals Behavioural risk factors in university students in Bucaramanga, Colombia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Martinez-Rueda ◽  
M A Camacho ◽  
I J Díaz
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Fruits And Vegetables ◽  
Protective Factor ◽  
Sedentary Time ◽  
Communicable Diseases ◽  
Activity Levels ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Behavioural Risk Factors

Abstract Background The changes generated in the studentś lifestyle due to the academic demands, may favour the prevalence of risk factors for non-communicable diseases as well as compromise other domains of their life. The purpose of this study was to establish the prevalence of behavioural risk factors in students of the Professional in Physical Activity and Sports program of a University in Bucaramanga, Colombia. Methods A cross-sectional study with a sample of 189 students was conducted. The students were surveyed with the first step of the STEPs questionnaire, which evaluates the behavioural risk factors for non-communicable diseases. A descriptive data analysis was performed, and Pearson tests were applied to determine the correlation between the analysed variables with a level of significance α = 0.05 using STATA 13.0. Results 80% of the participants were men. The age average was 22.7 ± 3.85 years. Regarding tobacco use, 10.1% of the participants were current smokers, while 30% smoked before. The majority of the participants (92.2%) have consumed alcohol within the past 12 months, while 69.8% consumed alcohol within the last month, with 8.7% of hazardous drinking. Concerning the diet, only 24.9% met the recommended consumption of fruits and vegetables per day. When assessing physical activity levels, only 6.3% were classified as physically inactive. Additionally, an average of 6 hours of sedentary behaviour was found, with 31.2% of excessive sedentary time. A weak correlation was found between age and academic cycle with the amount of physical activity at work (r = 0.24), (r = 0.18) and with sedentary time (r = -0.28), (-0, 32). Conclusions Although the prevalence of tobacco consumption was slightly higher than the national average, the students showed a lower prevalence of behavioural risk factors than the general population. However, it is necessary to promote strategies aimed at the control and prevention of these risk factors. Key messages Being a student of a program focused on physical activity and sport, can behave as a protective factor against the most prevalent risk factors in university life. It is necessary to implement more strategies centred on making students aware of the importance of the maintenance and improvement of their lifestyles in accordance with their professional profile.

scholarly journals How COVID-19 lockdown and reopening affected daily steps: evidence based on 164,630 person-days of prospectively collected data from Shanghai, China

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ding Ding ◽  
Minna Cheng ◽  
Borja del Pozo Cruz ◽  
Tao Lin ◽  
Shuangyuan Sun ◽  
...  
Keyword(s):  
Physical Activity ◽  
At Risk ◽  
Body Composition ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
University Education ◽  
Control Group ◽  
Daily Step ◽  
Step Counts ◽  
Reduced Physical Activity

Abstract Background COVID-19 lockdowns may lead to physical inactivity, a major risk factor for non-communicable diseases. This study aims to determine: 1) the trajectory in daily step counts before, during and after the lockdown in China, and 2) the characteristics associated with the trajectories. Methods From December 2019 to July 2020, smartphone-based step counts were continuously collected in 815 Chinese adults residing in Shanghai over 202 days across three phases: before, during, and after the lockdown. Participant characteristics were reported, and height, weight and body composition measured before the lockdown. A ‘sharp’ regression discontinuity design with cluster robust standard errors was used to test the effect of the lockdown and reopening on daily steps and a linear mixed model was used to examine the characteristics associated with trajectories during the observed period. Results Based on 164,630 person-days of data, we found a sharp decline in daily step counts upon the lockdown (24/01/2020) by an average of 3796 (SE = 88) steps, followed by a significant trend of increase by 34 steps/day (SE = 2.5; p < .001) until the end of the lockdown (22/03/2020). This increasing trend continued into the reopening phase at a slower rate of 5 steps per day (SE = 2.3; p = 0.029). Those who were older, married, university educated, insufficiently active, had an ‘at risk’ body composition, and those in the control group, were slower at recovering step counts during the lockdown, and those who were older, married, without university education and with an ‘at risk’ body composition recovered step counts at a slower pace after the reopening. Conclusions Despite later increases in step counts, COVID-19 lockdown led to a sustained period of reduced physical activity, which may have adverse health implications. Governments and health professionals around the world should continue to encourage and facilitate physical activity during the pandemic.

scholarly journals Effect of Resistance Training Along with Curcumin Supplementation on Expression of Some Regulator Genes Associated with Cardiac Muscle Structure in Obese Rats

Thrita ◽  
2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Atefeh Rauofi ◽  
Sirous Farsi ◽  
Seyed Ali Hosseini
Keyword(s):  
Physical Activity ◽  
Resistance Training ◽  
Cardiac Muscle ◽  
Muscle Atrophy ◽  
Synergistic Effects ◽  
Training Group ◽  
Control Group ◽  
Gene Expressions ◽  
Obese Rats ◽  
Reduced Physical Activity

Background: Reduced physical activity can cause obesity and metabolic syndrome, leading to fibrosis in cardiac muscles and premature cardiac aging. Physical activity, along with herbal supplements, can have a synergistic effect on preventing cardiac muscle proteolysis. Objectives: In this study, the effects of curcumin and resistance training were assessed on cardiac muscle atrophy in obese rats. Methods: Twenty-four male Sprague rats were categorized into four groups, including the placebo, resistance training, curcumin, and resistance training + curcumin. Resistance training was performed three times a week with three sets in each session, repeated five times for eight weeks. During this time, 150 mg/kg curcumin was administered through gavage. Twenty-four hours after finishing resistance training, surgery was performed on the cardiac muscle, and gene expressions of PGC1-α, FOXO1, Murf-1, Atrogin, Collagen1, and Collagen 3 were assessed with real-time PCR. Results: The expression of PGC1-α and FOXO1 genes in both resistance training and resistance training+curcumin groups significantly increased and decreased, respectively, compared to the control group (P = 0.001). The MuRF1 expression in the curcumin+resistance training group decreased significantly (P = 0.013) compared to the placebo and curcumin groups. The expression of collagen type 1 and type 2 in all the three treatment groups had significant decreases compared to the placebo group (P < 0.05). Conclusions: Considering the results of this study, resistance training and curcumin supplement each alone can prevent cardiac muscle atrophy. However, the simultaneous use of curcumin supplement and resistance training can lead to synergistic effects.

Effect of a 12-week workplace interview intervention on physical activity and low back pain: a single-center, randomized controlled study

2020 ◽  
Author(s):  
Kazuhiro Shimo ◽  
Mami Hasegawa ◽  
Seiko Mizutani ◽  
Tomomi Hasegawa ◽  
Takahiro Ushida
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapist ◽  
Intervention Group ◽  
Office Workers ◽  
Controlled Study ◽  
Control Group ◽  
Low Back ◽  
Face To Face

Abstract Background Physical activity (PA) is essential in the management and rehabilitation of low back pain (LBP). However, it is not clear if workplace PA interventions can improve LBP. This study aimed to investigate the effects of workplace interview intervention on increasing PA and improving LBP among office workers. Methods We recruited 37 workers of a manufacturing company in Aichi, Japan. Participants were randomly assigned to the intervention group (n=20) or control group (n=17). We affixed waist-worn accelerometers to monitor PA in all participants, and provided face-to-face counseling with a physical therapist or nurse once a week for 12 weeks as workplace PA program to reassurance and encourage participants to keep high levels of PA. PA and LBP severity were assessed at baseline, 3 and 6 months. Results Baseline characteristics were similar in both groups, but PA was significantly higher in the intervention group than in the control group at 3 and 6 months. In the intervention group, was PA significantly increased at 3 and 6 months from baseline and LBP severity improved significantly at 6 months from baseline. We calculated the effect size of the interview intervention, and found that workplace interview intervention had a medium to large effect on PA and LBP severity. Conclusions Our data suggests that workplace PA intervention can increase PA and improve LBP among office workers. Trial registration UMIN-CTR Clinical Trial UMIN000038864 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000044321). Registered 12 December 2019, retrospectively registered.

scholarly journals Frailty Level Monitoring and Analysis after a Pilot Six-Week Randomized Controlled Clinical Trial Using the FRED Exergame Including Biofeedback Supervision in an Elderly Day Care Centre

2019 ◽  
Vol 16 (5) ◽  
pp. 729 ◽  
Author(s):  
Iranzu Mugueta-Aguinaga ◽  
Begonya Garcia-Zapirain
Keyword(s):  
Physical Activity ◽  
Activities Of Daily Living ◽  
Day Care ◽  
Daily Living ◽  
Statistical Significance ◽  
Control Group ◽  
Study Group ◽  
State Of Health ◽  
Care Centre ◽  
Day Care Centre

Background: Frailty is a status of extreme vulnerability to endogenous and exogenous stressors exposing the individual to a higher risk of negative health-related outcomes. Exercise using interactive videos, known as exergames, is being increasingly used to increase physical activity by improving health and the physical function in elderly adults. The purpose of this study is to ascertain the reduction in the degree of frailty, the degree of independence in activities of daily living, the perception of one’s state of health, safety and cardiac healthiness by the exercise done using FRED over a 6-week period in elderly day care centre. Material and Methods: Frail volunteers >65 years of age, with a score of <10 points (SPPB), took part in the study. A study group and a control group of 20 participants respectively were obtained. Following randomisation, the study group (20) took part in 18 sessions in total over 6 months, and biofeedback was recorded in each session. Results: After 6 weeks, 100% of patients from the control group continued evidencing frailty risk, whereas only 5% of patients from the study group did so, with p < 0.001 statistical significance. In the case of the EQ-VAS, the control group worsened (−12.63 points) whereas the study group improved (12.05 points). The Barthel Index showed an improvement in the study group after 6 weeks, with statistically significant evidence and a value of p < 0.003906. Safety compliance with the physical activity exceeded 87% and even improved as the days went by. Discussion: Our results stand out from those obtained by other authors in that FRED is an ad hoc-designed exergame, significantly reduced the presence and severity of frailty in a sample of sedentary elders, thus potentially modifying their risk profile. It in turn improves the degree of independence in activities of daily living and the perception of one’s state of health, proving to be a safe and cardiac healthy exercise. Conclusions: The study undertaken confirms the fact that the FRED game proves to be a valid technological solution for reducing frailty risk. Based on the study conducted, the exergame may be considered an effective, safe and entertaining alternative.

Sign in / Sign up

Export Citation Format

Share Document