Therapeutic Exercise and Conservative Injection Treatment for Early Knee Osteoarthritis in Athletes: A Scoping Review

Background and Objectives: Recent evidence highlighted a higher prevalence of knee osteoarthritis (kOA) among young and former ex-professional athletes. Although the practice of a highly demanding sport is considered a predisposing factor for the knee joint cartilage degeneration, articular cartilage seems to positively respond to a moderate load increase. We aim to investigate recent evidence on the conservative management of early kOA in athletes, with a particular emphasis on therapeutic exercise and injection treatment, in order to highlight whether there are any indications that can influence clinical and rehabilitation practice. Materials and Methods: A scoping review was conducted, screening MEDLINE and PEDro databases for studies published over the past twenty years on the topic. Studies in English, with accessible abstracts, were included in the review. The PICO framework was used (P—patient: athletes, I—Intervention: conservative treatment with therapeutic exercise or injection therapies, C—Comparison: not needed, O—Outcomes: clinical outcomes). Clinical trials, randomized controlled trials, and longitudinal studies were considered. Results: Four studies were finally included in the review. Therapeutic exercise seems to have beneficial effects on prevention of cartilage degeneration, on pain reduction, and on physical function enhancement. On the other hand, in mild to moderate stages of kOA the intra-articular viscosupplementation with Hyaluronic Acid showed a medium to long-term improvement in joint pain and function. The Platelet Rich Plasma treatment also showed a significant improvement in pain and function up to 12 months. Conclusions: Despite the heterogeneity of the studies considered, a multimodal treatment combining therapeutic exercise and moderate aerobic activity (such as running) should be indicated to prevent kOA development. In cases of symptomatic kOA it may be indicated to add minimally invasive injection therapy that seems to contribute to the improvement of motor function and symptomatology.

Step Number and Aerobic Minute Exercise Prescription and Progression in Stroke: A Roadmap

Background While higher therapeutic intensity improves motor recovery after stroke, translating findings from successful studies is challenging without clear exercise intensity targets. We show in the DOSE trial 1 more than double the steps and aerobic minutes within a session can be achieved compared with usual care and translates to improved long-term walking outcomes. Objective We modeled data from this successful higher intensity multi-site RCT to develop targets for prescribing and progressing exercise for varying levels of walking impairment after stroke. Methods In twenty-five individuals in inpatient rehabilitation, twenty sessions were monitored for a total of 500 one-hour physical therapy sessions. For the 500 sessions, step number and aerobic minute progression were modeled using linear mixed effects regression. Using formulas from the linear mixed effects regression, targets were calculated. Results The model for step number included session number and baseline walking speed, and for aerobic minutes, session number and age. For steps, there was an increase of 73 steps per session. With baseline walking speed, for every 0.1 m/s increase, a corresponding increase of 302 steps was predicted. For aerobic minutes, there was an increase of .56 minutes of aerobic activity (ie, 34 seconds) per session. For every year increase in age, a decrease of .39 minutes (ie, 23 seconds) was predicted. Conclusions Using data associated with better walking outcomes, we provide step number and aerobic minute targets that future studies can cross-validate. As walking speed and age are collected at admission, these models allow for uptake of routine measurement of therapeutic intensity. Registration: www.clinicaltrials.gov ; NCT01915368.

Brain Changing Advantages of Exercise

Exercise is defined as any activity that causes your muscles to work and your body to burn calories. Physical activity includes swimming, running, jogging, strolling, and dancing, to name a few. Physically and mentally active people have been shown to have various health benefits. It could even help you live a longer life. In this article, we attempt to explain the beneficial effects of exercising regularly on our brain and how this helps with cognitive tasks. We also describe the various neurotrophic neurochemicals that aid in this phenomenon. We then describe the process of neuroplasticity and how exercise can help accelerate this process. Regular physical activity is one of the most important things you can do for your health. If you're worried about being harmed if you start walking or increase your level of physical activity, it is safe for most people to engage in moderate-intensity aerobic activity, such as brisk walking. Reduced emotions of state anxiety (short-term anxiety), increased sleep, and enhanced elements of cognitive performance are some of the benefits of moderate or intense physical exercise on cerebral health that happen immediately after moderate or intense physical activity (acute impact). People who engage in more moderate or intense physical activity generally have better mental processes to gain knowledge and comprehension than those who do not. Improvements in cognition, as well as performance, might be expected. For example, standardized assessments of academic achievement and performance on mental ability tests are examples of neuropsychological testing. Processing speed, memory, and executive function are all factors to consider.

The Role of Physical Aerobic Activity in Controlling Exercise-Induced Bronchoconstriction in Children and Adolescents with Asthma

Asthma, one of the major widespread chronic disorders among children and adolescents, has become more prevalent recently. The common manifestations of this disorder are caused by inflammatory airways that lead to airway restriction and lung hypersensitivity causing dry coughing, wheezing, and shortness of breath, all of which are combined with sleep disturbance, impaired physical activity, and reduced quality of life. The main goal of this brief review was to identify the associated variables that affect the management of asthma disease in children and young adolescents and to identify the role of physical aerobic exercise in the treatment of asthmatic children. The current review was based on prior research published in English databases such as Google Scholar, PubMed, and Embase in scientific articles published between January 2010 and October 2021 with the keywords "asthma," "children," "adolescents," "breathing episodes," "physical activity," and "physical exercise." Regular physical aerobic exercise training with moderate intensity has been shown to improve pulmonary functions, life quality, psychological conditions, and reduce asthma symptoms and EIB in children and adolescents with bronchial asthma.

Lessons Learned in the Delivery of Live Remote Group Weight Loss and Physical Activity Interventions for Older Adults

Social connection lies at the root of lasting health behavior change, and as such most effective interventions are built around social tools. Group leaders and peers provide education, and act as models of successful change and collaborators in addressing common barriers to behavioral adoption and maintenance. Unfortunately, many older adults do not have access to high quality group programs due to factors such as limited transport options, lack of local availability, or worries over personal safety. Importantly, developing effective, synchronous remote group programming is not as simple as delivering an in-person session via teleconference software. Instead, careful consideration must be paid to technology selection, fostering effective group communication, and developing confidence for use of remote intervention tools. This symposium provides key lessons learned from three group-based activity and weight loss interventions for older adults that focused on live, remote interaction. Jason Fanning will share lessons from the MORPH study, which paired remote group-mediated behavioral counseling with dietary weight loss and the accumulation of aerobic activity across the day. Christina Hugenschmidt will share her experiences adapting a group program involving improvisational dance or social gaming for remote delivery. Kushang Patel will present results from a mixed-methods study on the feasibility and acceptability of a remotely-delivered exercise program for older adults with knee osteoarthritis. Finally, Barbara Nicklas will place these experiences in the context of the development of exercise interventions for older adults over time, and highlighting vital next steps for ensuring more older adults have access to this important behavioral medicine.

A Primer on Systematic Reviews and Meta-Analyses: Part I

ABSTRACT The conduct of systematic reviews and meta-analyses are a cornerstone source of information required for evidence-based practice in all medical and allied health professions. Meta-analyses are important in the exercise sciences because, for instance, sometimes many small underpowered studies may suggest the optimal treatment deviates from the generic guidelines that suggest 30 minutes to 60 minutes of moderate intensity aerobic activity 3 to 5 times weekly, supplemented by 1 or more sessions of resistance exercise. A systematic review and meta-analysis can help by combining studies to increase power and provide an answer. The signature method of presenting results of meta-analyses is the forest plot, and an ability to interpret these data and the associated funnel plots are essential to the practice of evidence-based exercise programming. This work describes the processes of systematic review and meta-analysis and informs the reader on how these works may be presented, interpreted, and applied. Some examples from the field of kinesiology and exercise physiology are presented to illustrate how the results of a meta-analysis may influence evidence-based practice.

Excessive energy expenditure due to acute physical restraint disrupts Drosophila motivational feeding response

To study the behavior of Drosophila, it is often necessary to restrain and mount individual flies. This requires removal from food, additional handling, anesthesia, and physical restraint. We find a strong positive correlation between the length of time flies are mounted and their subsequent reflexive feeding response, where one hour of mounting is the approximate motivational equivalent to ten hours of fasting. In an attempt to explain this correlation, we rule out anesthesia side-effects, handling, additional fasting, and desiccation. We use respirometric and metabolic techniques coupled with behavioral video scoring to assess energy expenditure in mounted and free flies. We isolate a specific behavior capable of exerting large amounts of energy in mounted flies and identify it as an attempt to escape from restraint. We present a model where physical restraint leads to elevated activity and subsequent faster nutrient storage depletion among mounted flies. This ultimately further accelerates starvation and thus increases reflexive feeding response. In addition, we show that the consequences of the physical restraint profoundly alter aerobic activity, energy depletion, taste, and feeding behavior, and suggest that careful consideration is given to the time-sensitive nature of these highly significant effects when conducting behavioral, physiological or imaging experiments that require immobilization.

Comparison of four different training programs in body composition and strength in women over 55 years

There is no doubt of the benefits brought by the practice of physical exercises in the promotion of health, but the use of combined capacities in a same session is still contradictory. The aim of the present study was to verify the influence of a 10- week program of concurrent training on body composition and strength in adult women comparing it to programs of strength and aerobic activities. Thirty women were selected with minimum age of 55 years, randomized in four groups: group A1 (aerobic activity following by strength training), group F1 (strength training followed by aerobic activity), group A (aerobic training), group F (strength training). The body fat showed differences among the groups, the group F was significantly lower than A and A1; when strength was analyzed the results demonstrated differences in the lumbar area in the group A1 and in the strength of inferior members in A, A1 and F from pre- to post-test. Based on the data, we conclude that excepting of body composition, there is no variance in the analyzed variables in this group of women according to the type of training performed.

Trends in Aerobic and Muscle-Strengthening Physical Activity by Race/Ethnicity Across Income Levels Among US Adults, 1998–2018

Background: Although disparities in leisure-time physical activity (LTPA) participation by race/ethnicity and income are known, the combined association of these characteristics with LTPA participation is less understood. This study aims to describe trends and determine whether racial/ethnic differences in adult physical activity by income level have changed over the past 2 decades. Methods: The authors estimated LTPA participation (outcomes: any aerobic activity, meeting the aerobic activity guideline, meeting the muscle-strengthening guideline, and meeting the combined aerobic and muscle-strengthening guidelines) among adults ≥18 years by race/ethnicity across income levels using 1998–2018 National Health Interview Survey data in 3-year aggregates. They also tested for trends, prevalence differences, and difference in differences using logistic regression. Results: LTPA participation increased from 1998–2000 to 2016–2018 for all outcomes for non-Hispanic white, non-Hispanic black, and Hispanic adults at all income levels. Disparities narrowed for some groups but persisted between white and racial/ethnic minority groups across income levels for engaging in any aerobic activity and meeting the aerobic guideline (0.2–8.8 percentage point difference in differences). Disparities in meeting the muscle-strengthening and combined guidelines were less common. Conclusions: Opportunities exist to ensure that adults, particularly members of lower income racial/ethnic minority groups, have support to help them participate in LTPA.