Search Results (6,262)

Background/Objectives: This systematic and bibliographic review examines publications in the field of dementia and video game research from 2004 to 2023. The main objective is to assess developments and trends in video game technology for dementia care and detection. Methods: The PubMed database was the primary source for publications. PRISMA guidelines were applied to structure this review. Ten variables were defined, investigated, and split into three main categories: bibliographic, medical, and technical. Results: The results were synthesized using a quantitative approach to reduce bias through interpretation. Of 209 initial results, 77 publications have been included in the investigation. More studies focus on rehabilitation over assessment and detection of dementia. Clinical trials are typically conducted with limited participants. The most populated trials rarely enrol over 300 subjects. On average, around 38 subjects were enrolled in the trials. These studies are commonly supervised by a trainer or technology specialist, suggesting a technology gap in familiarity in the trial demographic. Conclusions: Most interventions assessed were custom-designed applications with a specific outcome, focusing on physical activity and cognitive exercises. As the first of its kind, this publication focuses on the technical aspects of applied technologies and development methods. Using video games to treat and detect patients with cognitive impairments like dementia can benefit healthcare professionals, caretakers, and patients. Full article

The brain-derived neurotrophic factor (BDNF) is a crucial protein in the development of the cognitive system. It regulates the growth of neurons and glial cells, synaptic plasticity, and neuroprotection. Background/Objectives: It has been suggested that high-intensity exercise could modulate the mechanisms of BDNF release, with potentially significant implications in the professional sports world. However, this is not yet fully proven, and the underlying physiological alterations are unknown. Methods: This paper reviews the current scientific literature to clarify the uncertainties about how high-intensity physical exercise influences BDNF release and its relationship with high-performance sports. Results: Strenuous exercise appears to increase BDNF synthesis through the action of lactate and the PGC-1α/FNDC5 pathway. Additionally, cognitive function has been described as an element to consider for maximizing sports performance. Conclusions: In this regard, this review provides a solid starting point for further investigation into the molecular mechanisms that promote BDNF expression mediated by exercise, as well as for seeking a direct correlation between the role of cognitive development and athletic performance in high-performance athletes. Full article

Background: Type 2 diabetes mellitus is a metabolic disorder characterized by insulin resistance (IR), which is prevalent worldwide and has significant adverse health effects. Metformin is commonly prescribed as a pharmacological treatment. Physical exercise is also recognized as an effective regulator of glycemia, independent of metformin. However, the effects of inter-day concurrent training (CT)—which includes both endurance and resistance exercises—combined with metformin treatment on metabolic markers and cardiorespiratory fitness in individuals with IR remain controversial. Objective: This study aimed to analyze the effects of a 12-week inter-day CT program on metabolic markers and cardiorespiratory fitness in overweight/obese individuals with IR, both with and without metformin treatment. Additionally, inter-individual responses to CT were examined. Materials and Methods: Data from the 2022–2023 Obesity Center database were retrospectively analyzed. According to the eligibility criteria, 20 overweight/obese individuals diagnosed with IR participated in a 12-week CT program (three weekly sessions: two endurance and one resistance exercise session). Participants were divided into three groups: the exercise group (E-G: n = 7, 32.86 ± 8.32 years, 85.2 ± 19.67 kg), the exercise–metformin group (E-MG: n = 6, 34.83 ± 12.91 years, 88.13 ± 12.66 kg), and the metformin-only control group (M-G: n = 7, 34.43 ± 13.96 years, 94.23 ± 13.93 kg). The M-G did not perform physical exercise during the 12 weeks but continued pharmacological treatment. Body composition, metabolic markers, and cardiorespiratory fitness were assessed before and after the 12-week CT program. Results: A group-by-time interaction was observed for fasting insulin (F_2,17 = 34.059, p < 0.001, η²_p = 0.88), the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (F_2,17 = 35.597, p < 0.001, η²_p = 0.80), and maximal fat oxidation (MFO) (F_2,17 = 4.541, p = 0.026, η²_p = 0.348) following the CT program. The maximal oxygen uptake (VO2_max) showed significant improvements in the E-G (F = 4.888, p = 0.041, ∆+13.3%). Additionally, the percentage of fat mass (%FM) and body mass (BM) were significantly reduced across all groups (F = 125.244, p < 0.001 and F = 91.130, p < 0.001, respectively). The BM decreased by ∆−9.43% in the E-G (five responders, Rs), ∆+9.21% in the EM-G (5 Rs), and ∆+5.15% in the M-G (3 Rs). The %FM was reduced in the E-G by ∆−22.52% (seven Rs). Fasting insulin and the HOMA-IR significantly improved in both the E-G and EM-G, with fasting insulin showing a ∆−82.1% reduction in the E-G (five Rs) and a ∆−85% reduction in the EM-G (six Rs). Similarly, the HOMA-IR improved by ∆+82.6% in the E-G (three Rs) and by ∆+84.6% in the EM-G (six Rs). Conclusions: The 12-week inter-day concurrent training program, whether combined with metformin or not, was similarly effective in improving metabolic markers in patients with insulin resistance as metformin treatment alone. Both exercise groups demonstrated a significant reduction in insulin sensitivity and an increase in maximal fat oxidation. Meanwhile, exclusive pharmacological treatment with metformin markedly decreased cardiorespiratory fitness, and consequently, fat oxidation. Full article

Background and Objectives: Adjuvant treatment with aromatase inhibitors (AIs) in breast cancer (BC) survivors can cause adverse effects such as metabolic syndrome (MS) (insulin resistance, central obesity, atherogenic dyslipidemia, and hypertension) associated with morbidity and premature mortality. We evaluate the effect of a multimodal program based on physical exercise and health education on MS and health-related quality of life (QoL) in postmenopausal women with BC under AIs. Methods: A total of 56 postmenopausal women, diagnosed with BC, aged 60 years or older (mean age 67.2 years) and on hormonal treatment with AIs, were included in the multimodal physical exercise and health education program, and evaluated before and after their participation. The assessment of the five criteria of the MS included the following: waist circumference, high blood pressure, fasting glucose, triglycerides, and high-density lipoprotein cholesterol. Two main instruments were used to evaluate the impact of the intervention on QoL: the EORTC QLQ C30 (questionnaire for cancers in general) and the EORTC QLQ BR23 (specifically for breast cancer patients). The EuroQol 5D (EQ-5D) was also used to compare these results. Results: The percentage of women meeting the MS criteria was 37.7% at baseline and fell to 15.1% at 3 months after the intervention (p = 0.02). The intervention significantly reduced hypertension (p < 0.001), central obesity (p < 0.001), and the concentration of triglycerides (p = 0.016). No significant changes were observed in fasting glucose and HDL concentration. A statistically significant improvement was found in QoL (on both the QLQ30 and BR23 scales). A multivariate regression model analysis identified marital status (being married) (95% CI: 1.728–131.615, p = 0.014), and percentage of attendance at health education sessions (95% CI: 1.010–1.211, p = 0.029) as positive predictive variables of improvement in MS. Conclusions: The implementation of multimodal, community-based programs of physical exercise and health education improve the prevalence of MS and specific criteria of MS and QoL in postmenopausal women with breast cancer receiving AI treatment. Full article

Regular exercise has been shown to have a positive effect on the health outcomes of individuals with type 2 diabetes mellitus (T2DM); however, it is still underutilized in developing countries. This study investigated diabetes-related knowledge, attitudes, and practice toward exercise and its benefits among individuals with T2DM. A total of one hundred and ninety-nine participants (male = 21.6% and female = 78.4%) with T2DM, aged between 18 and 75, (43.77 SD± 14.78) years, participated in the study. A validated diabetes-related knowledge, attitude, and practice questionnaire, evaluated by true/false or unsure, was utilized in the study. Descriptive and inferential statistics analysis was used to analyze data with the significance set at p < 0.05. The results demonstrated poor diabetes-related knowledge of exercise (p < 0.001). The majority of the study participants, 163 (81.90%) with T2DM, did not know that physical activity and exercise are different. About 158 (70.40%) of the study participants felt that their regular work was an adequate substitution for exercise. More than 50% of the study participants demonstrated a positive practice towards exercise and its benefits towards T2DM (p < 0.001). The majority of the study participants reported poor knowledge and a negative attitude toward diabetes. However, their diabetes-related practices were satisfactory. Full article

Introduction: Low levels of cardiorespiratory fitness (CRF) are associated with a greater risk of metabolic syndrome (MetS) in adolescence. In this sense, it is important to verify the strength of this association and the certainty that this evidence can be recommended. Objective: The objective of this paper is to summarize, through a systematic review and meta-analysis, the evidence available to verify the association between CRF and MetS in adolescents. Methods: PubMed, Embase, CINAHL, SPORTDiscus, LILACS, and Web of Science were searched until 20 August 2024. The risk of bias in each study was assessed via the AXIS tool, and the certainty of the evidence was assessed via the GRADE system. For the meta-analysis, the odds ratio (OR) was calculated with a 95% confidence interval. Results: Nine studies (7077 participants), all with a low risk of bias, were included in the systematic review. There was a high certainty of evidence that adolescents with low CRF have significantly greater odds of developing MetS (OR = 3.63 [CI 95%, 2.54 to 5.20]). The odds increase for low vs. moderate (OR = 4.23 [CI 95%, 2.64 to 6.78]) and low vs. high (OR = 8.03 [CI 95%, 3.20 to 20.18]) CRF are considered separately. The effect does not change according to the type of test used to assess CRF (p = 0.51). Conclusions: There is high certainty of evidence that adolescents with low CRF levels have significantly greater odds of developing MetS; therefore, it is essential that intervention strategies be designed to increase CRF in this population. Full article

Background/Objectives: Dementia involves the loss of cognitive abilities and impairs functional abilities in daily life. In motor imagery (MI) techniques, motor acts are mentally rehearsed without any overt body movements. The purpose of the randomized controlled trial was to examine the effects of MI on the motor function of older adults with dementia. Methods: Overall, 160 participants (43 men, 117 women, MMSE M = 23.20, SD = 0.15) from an Athens Day Care Center of the Alzheimer Association were randomized to (a) the MI and exercise group (experimental group) (n = 55), (b) the only exercise group (1st control group) (n = 52) and (c) the neither MI nor exercise group (2nd control group) (n = 53). The exercise session comprised 24 physiotherapy exercise sessions, lasting 45 min each, twice a week for 12 weeks. The exercises were selected from the Otago Exercise Program. Three assessments were performed: (a) one week prior to the program, (b) at one and a half months and (c) after the program. The experimental group performed a 30-minute MI with exercise program content after the end of every physiotherapy exercise session. The Multidirectional Reach Test, Five Times Sit-to-Stand Test (FTSST), Timed Up and Go test (TUG), Functional Gait Assessment (FGA) and Berg Balance Scale (BBS) were used to assess participants’ balance and functional status. Results: In the intention to treat analysis (18 participants dropped out), the 3 × 3 repeated measures ANOVA indicated statistically significant results between the three groups on (a) the TUG (F = 3.06, df (2), p = 0.04), (b) the FTSST (F = 3.00, df (2), p = 0.05), (c) the forward direction test (F = 4.14 df (2), p = 0.02), the lateral right and the lateral left direction tests (F = 3.90, df (2), p = 0.02 and F = 7.87, df (2), p = 0.00, respectively), and (d) the FGA (F = 4.35, df (2), p = 0.01). The Friedman test showed significant statistical significant differences among the three groups for BBS (X² = 7.62, df = 2, p = 0.22), and an effect size of partial η² coefficient for F-tests was found. Post hoc comparisons using a Bonferroni test for ANOVA and Wilcoxon test for Friedman indicated that the mean scores for the experimental group and the 1st control were significantly better than the 2rd control group in many dependent variables. Conclusions: The study showed a positive effect of MI on balance and the functional status of older adults with early stages of dementia with possible beneficial effects on maintaining independence and reducing physical decline. Full article

(1) Background: Growth in the use of video games has spurred innovations in the health sector, especially through exergames, which promote physical activity using interactive technologies like augmented reality. Exergames are shown to enhance exercise motivation and engagement, yet enjoyment remains inconsistent across studies. This pilot study aims to provide evidence on how different exergaming doses affect exercise heart rate, perceived exertion, adverse effects, and enjoyment in older adults. (2) Methods: A pilot randomized controlled trial was conducted to compare different doses of exercise through video games (13 vs. 28 min) in older adults living in a nursing home. A single bout of exergaming was provided to assess the outcomes: heart rate, rate of perceived exertion, physical activity enjoyment scale score, and adverse effects. (3) Results: Thirty-two older adults were recruited. This study revealed no significant differences in heart rate between groups (p = 0.1). There is a weak correlation between the rate of perceived exertion and the level of enjoyment (r_s = −0.193) and between the total time of the intervention and the incidence of adverse effects (r_s = 0.295). (4) Conclusions: The use of a higher dose of exergaming is effective in achieving moderate physical intensity. Also, the results suggest the intervention was generally well tolerated and enjoyed by older adults, with no serious adverse effects reported. Full article

The aim of this study was to assess the effects of an 8-week cognitive-motor training program on postural control and knee proprioception under single and dual task conditions. Design: Randomized clinical trial. Methods: The present study was registered with the ID number NCT04786132. A total of 20 healthy and physically active older adults (73.25 ± 5.98 years) volunteered to participate and were randomly assigned into an experimental and a control group (EG and CG). Postural control was measured with the Romberg test, with open (RBOE) and closed eyes (RBCE) and under unipodal dominant side (RUDL) conditions. Proprioception was assessed by measuring participants’ ability to reposition their dominant knee at 45°. Finally, performance of the cognitive task was measured through a subscale of the Barcelona Test called “categorical evocation in associations”. The EG and the CG completed 8-week training programs with two sessions, 30 min per week, of postural control and proprioception exercises. The EG additionally included music in each session. Results: The analysis using a mixed ANOVA model revealed no significant group × time interaction effects (p < 0.05) for any of the assessments. However, a significant main effect for the time factor was observed, with both the control and experimental groups showing improved outcomes in the post-intervention measurements. Specifically, significant results were found for RBOE (F (4,15) = 11.87, p < 0.001, η²p = 0.76), RBCE (F (4,15) = 11.62, p < 0.001, η²p = 0.75), and proprioception (F (1,18) = 11.53, p < 0.003, η²p = 0.39). Conclusions: The 8-week training program had a positive impact on the post-intervention results for motor control and proprioception, but not on the results of the cognitive task. There were no significant differences between the groups that carried out sessions with or without music. Full article

Individual physiotherapy is crucial in treating patients with various pain and health issues, and significantly impacts abdominal surgical outcomes and further medical problems. Recent technological and artificial intelligent advancements have equipped healthcare professionals with innovative tools, such as sensor systems and telemedicine equipment, offering groundbreaking opportunities to monitor and analyze patients’ physical activity. This paper investigates the potential applications of mobile accelerometers in evaluating the symmetry of specific rehabilitation exercises using a dataset of 1280 tests on 16 individuals in the age range between 8 and 75 years. A comprehensive computational methodology is introduced, incorporating traditional digital signal processing, feature extraction in both time and transform domains, and advanced classification techniques. The study employs a range of machine learning methods, including support vector machines, Bayesian analysis, and neural networks, to evaluate the balance of various physical activities. The proposed approach achieved a high classification accuracy of 90.6% in distinguishing between left- and right-side motion patterns by employing features from both the time and frequency domains using a two-layer neural network. These findings demonstrate promising applications of precise monitoring of rehabilitation exercises to increase the probability of successful surgical recovery, highlighting the potential to significantly enhance patient care and treatment outcomes. Full article

Introduction: Leptin and ghrelin are two hormones that play a role in weight homeostasis. Leptin, which is produced primarily by adipocytes and is dependent on body fat mass, suppresses appetite and increases energy expenditure. Conversely, ghrelin is the “hunger hormone”, it stimulates appetite and promotes fat storage. Bariatric surgery significantly alters the levels and activity of these hormones, contributing to weight loss and metabolic improvements. Clarifying the interplay between bariatric surgery, weight loss, physical exercise, leptin, and ghrelin is essential in developing comprehensive strategies for optimizing the long-term outcomes for candidates who have undergone bariatric surgery, especially for sarcopenic patients. Methods: This was a randomized controlled study with two groups (n = 22). The patients in both groups had obesity and sarcopenia. A Roux-en-Y-gastric bypass (RYGB) procedure was performed on all patients. The intervention group participated in a structured exercise program three times per week, beginning one month after surgery and lasting 16 weeks. Patient assessment was performed before surgery (baseline) and after the completion of the exercise program. The control group received the usual standard of care and was assessed similarly. Results: After surgery, weight, BMI, and lean mass decreased significantly in both groups between the baseline and the second assessment. Leptin levels were not significantly different between baseline and the second assessment in the physical exercise group, but were significantly lower in the control group (p = 0.05). Ghrelin levels increased over time in both groups, but the differences were not significant. When we associated leptin (the dependent variable) with weight (the independent variable), we found that lower weight was associated with lower leptin levels. A similar relationship was also observed between the leptin and sarcopenia parameters (muscle strength and mass), as well as in the bone health parameters (bone mineral density and t-score). Higher ghrelin levels were significantly associated with higher t-scores and z-scores (p < 0.05). Conclusion: Exercise has been shown to have a significant effect on leptin and ghrelin levels after bariatric surgery. By incorporating regular physical activity into their lifestyle, bariatric patients can optimize their weight loss outcomes and improve their overall health. After the physical exercise protocol, patients in the intervention group revealed more established leptin levels, which may indicate a protected pattern concerning decreased leptin levels. An unfavorable profile was evidenced, according to which greater weight loss, sarcopenia, and osteoporosis were associated with lower leptin levels. Full article

Background/Objectives: The extensive range of instruments designed for evaluating functional performance (FP) in chronic respiratory diseases (CRD) other than chronic obstructive pulmonary disease (COPD) presents a challenge in selecting the most appropriate one. Therefore, this systematic review aimed to summarise FP instruments, their measurement properties, their minimum clinically important differences, and their associations with CRD course-related events or prognosis in non-COPD CRD. Methods: Studies employing patient-reported or performance-based instruments to assess FP in non-COPD CRD were systematically identified in the PubMed, PEDro, Embase, and Cochrane Library databases. COPD-exclusive studies or those solely reporting exercise capacity tests were excluded. Examination focused on measurement properties and associations with CRD course-related events or prognosis. The risk of bias was evaluated using the COSMIN, Downs and Black, and PEDro checklists based on the study design. Results: A total of 216 studies across seven CRD categories [asthma, bronchiectasis, cystic fibrosis, interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), pre-/post-lung-transplantation] from various study types were included. Thirty-three instruments were identified, with the SF-36 questionnaire’s physical function domain being the most commonly used patient-reported tool. The 1 min sit-to-stand test was the most extensively studied performance-based measure, with its measurement properties frequently reported in non-COPD CRD studies. Associations with events were infrequently documented, primarily in ILD and PAH studies related to mortality. Conclusions: Despite the prevalent use of FP instruments, limited information exists concerning their measurement properties and clinical implications. This review furnishes a concise summary of available evidence, aiding informed clinical decisions when selecting FP tools for non-COPD CRD. Full article

Background: Long-COVID, which might develop after a SARS-CoV-2 infection, is a rather new disease without standardized treatment strategies. A large number of approaches that integrate physical activity have been described in the literature, and this systematic review aims to examine changes in symptom severity, physical fitness, respiratory symptoms and quality of life during training and identify factors that might influence the respective outcomes. Methods: A literature search was conducted using the databases Pubmed, PEDro, BioMed Central, EBSCOhost, ProQuest and the ZBSport from 13 February 2024 to 27 February 2024, and 39 studies fulfilled the search criteria. Results: The analyzed study designs varied regarding the type of intervention (isolated vs. multidisciplinary), duration and intensity of training sessions and overall length of the program. Individualized holistic concepts of physical activity paralleled by additional approaches demonstrated high effectiveness. However, many of the participants continue to suffer from Long-COVID after the intervention. Conclusions: Long-COVID treatment should be individualized, multifactorial and not limited in time and should consider each patient’s pre-existing conditions and individual course of the disease to provide the best possible support and care. Full article

This study aimed to examine the acute effects of squat and ballistic jump exercises during warm-ups on judo-specific performance in young male judokas. Using a randomized crossover design, 10 sub-junior male judokas (age: 12.9 ± 0.7 years) completed three conditions: a controlled warm-up with only judo-specific exercises and two experimental warm-ups including either a three-repetition maximum (RM) back squat (with ~90% 1RM load) or ballistic jumps (squat jumps, scissor jumps, and double-leg bounds) in addition to judo-specific warm-ups. Following each warm-up condition, participants performed the Special Judo Fitness Test (SJFT), with heart rate measured immediately and one minute post-test. Handgrip strength and ratings of perceived exertion (RPE) were recorded after the SJFT. Both squat and ballistic jump exercises significantly improved judo-specific performance compared to the control condition, with large effect sizes (ESs). The number of throws in set 2 (p = 0.001, η_p² = 0.65, large ES), total throws (p < 0.001, η_p² = 0.70, large ES), and the SJFT index (p < 0.001, η_p²= 0.65, large ES) all showed significant improvements. Regarding the throw in set 2, significant improvements were observed after both squat (p = 0.003, Hedge’s g = 1.78, large ES) and ballistic jump exercises (p = 0.010, Hedge’s g = 1.44, large ES) compared to the control condition. Similarly, total throws were significantly higher in the squat (p = 0.003, Hedge’s g = 1.51, large ES) and ballistic jump (p < 0.001, Hedge’s g = 1.37, large ES) conditions compared to the control condition. Furthermore, the SJFT index showed notable improvements following squat (p = 0.010, Hedge’s g = 0.80, moderate ES) and ballistic jump (p < 0.001, Hedge’s g = 0.90, moderate ES) conditions compared to control conditions. However, squat exercises led to a significant reduction in right-hand grip strength (p < 0.001, η_p² = 0.58, large ES) [p = 0.008, Hedge’s g = 0.19, trivial ES for squat vs. control; p = 0.014, Hedge’s g = 0.23, small ES for squat vs. ballistic jump], with no differences observed in left-hand grip strength or RPE scores (p > 0.05). In conclusion, the integration of squat and ballistic jump exercises into warm-up protocols has been shown to significantly improve judo-specific performance in young male judokas without eliciting an increase in RPE values. However, careful consideration should be given when incorporating squat exercises, as they may lead to localized handgrip fatigue (reduced grip strength due to muscle exhaustion), which could affect performance in grip-dependent techniques. Full article

Exercise-based cardiac rehabilitation (ExCR) programs are essential for patients diagnosed with cardiac diseases. Studies have shown that they aid in the rehabilitation process and may even facilitate a return to previous cardiorespiratory fitness. Also, patients who enroll and follow such programs have shown a lower rate of complications and mortality in the long run. The results vary depending on the type of program followed and the degree of debilitation the disease has caused. Therefore, in order to obtain optimal results, it is ideal to tailor each ExCR program to the individual profile of each patient. At the moment, the two most studied and employed training types are medium-intensity continuous training (MICT) and high-intensity interval training (HIIT). For most of the time, MICT was the first-choice program for patients with cardiovascular disease. In recent years, however, more and more studies have pointed towards the benefits of HIIT and how it better aids patients in recovering their cardiovascular fitness. Generally, MICT is more suited for patients with a severe degradation in functional capacity and who require a higher degree of safety (e.g., elderly, with a high number of comorbidities). On the other hand, while HIIT is more demanding, it appears to offer better outcomes. Therefore, this review aimed to summarize information from different publications on both types of training regimens in ExCR and assess their utility in current clinical practice. Full article