Relationship of Arterial Tonometry and Exercise in Patients With Chronic Heart Failure: a Systematic Review With Meta-analysis and Trial Sequential Analysis

BackgroundArterial stiffness is a common characteristic in patients with chronic heart failure (CHF), and arterial tonometric technologies related to arterial stiffness are novel and effective methods and have an important value in the diagnosis and prognosis of CHF. In terms of ameliorating arterial stiffness in patients with CHF, exercise training is considered an adjuvant treatment and also an effective means in the diagnosis and judgment of prognosis. However, there are huge controversies and inconsistencies in these aspects. The objective of this meta-analysis was to systematically test the connection of arterial tonometry and exercise in patients with CHF.Methods and resultsMEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library were searched from inception to 2 June 2021. Eighteen articles were included, with a total of 876 participants satisfied the inclusion criteria. The pooling revealed that flow-mediated dilation (FMD) was lower in basal condition [standardized mean difference (SMD): -2.28%, 95% confidence interval (CI): -3.47 to -1.08, P<0.001] and improved significantly after exercise (SMD: 5.96%, 95%CI: 2.81 to 9.05, P<0.001) in patients with heart failure with reduced ejection fraction (HFrEF) compared with normal participants. High-intensity training exercise was more beneficial (SMD: 2.88%, 95% CI: 1.78 to 3.97, P<0.001) than moderate-intensity training exercise to improve FMD in patients with CHF. For augmentation index (AIx), our study indicated no significant differences (SMD: 0.50%, 95% CI: -0.05 to 1.05, p = 0.074) in patients with heart failure with preserved ejection fraction (HFpEF) compared with normal participants. However, other outcomes of our study were not identified after further verification using TSA, and more high-quality studies are needed to reach definitive conclusions in the future.ConclusionsThis review shows that FMD is lower in basal condition and improves significantly after exercise in patients with HFrEF compared with normal participants; high-intensity training exercise is more beneficial than moderate-intensity training exercise to improve FMD in patients with CHF; besides, there are no significant differences in AIx in patients with HFpEF compared with normal participants. More high-quality studies on this topic are warranted.

The association of osteoporosis knowledge and beliefs with preventive behaviors in postmenopausal breast cancer survivors

Background Postmenopausal breast cancer survivors (PBCS) are at increased risk of bone loss and fractures due to age-related decline of estrogen, and this risk is compounded by aromatase inhibitor cancer therapy. Several patient-level targetable risk factors can mitigate osteoporosis risk; however, adequate health behavior and risk perception in this population are underreported. The goal of this study was to evaluate osteoporosis knowledge and beliefs and assess their association with engagement in osteoporosis preventive behaviors among PBCS. Methods In this cross-sectional descriptive study, early stage I–IIIA PBCS (ages 55–86 years) completed the Facts on Osteoporosis Quiz, Osteoporosis Health Beliefs Scale, and Osteoporosis Preventive Behaviors questionnaires. Participants who were non-English speaking or declined to participate were excluded. Clinical and sociodemographic information were obtained from chart review and baseline questionnaire, respectively. Fisher’s exact test, Student t-test, and Wilcoxon Mann–Whitney tests were used where appropriate to assess the association between knowledge and beliefs with engagement in osteoporosis preventive behaviors. Results The mean participant age was 66.1 years with 20% self-reporting as non-Hispanic White, 40% non-Hispanic Black, 27% Hispanic, and 13% other. Approximately 83% of the cohort had estrogen receptor positive breast cancer and received a bone density scan within the last six years. Osteoporosis knowledge (10.5 ± 3.4), seriousness (14.9 ± 3.8), and susceptibility (14.0 ± 3.5) mean scores were low among PBCS. Most PBCS (75%) were adherent to calcium and vitamin D supplements, but only 47% reported engagement in strength-training exercises. Married/partnered, higher osteoporosis knowledge and health motivation scores were associated with strength-training exercise. After adjustment for marital status and osteoporosis knowledge, only health motivation score remained significantly associated with strength-training exercise (OR 5.56, 95% CI 1.35–22.93). Conclusions PBCS are highly motivated to keep a healthy lifestyle despite limited osteoporosis knowledge, perceived risk, and susceptibility. However, < 50% participated in strength-training exercise. Our findings suggest that oncologic care should include osteoporosis and fracture prevention strategies, directed at encouraging cancer survivors to increase their engagement in osteoporosis preventive behaviors, particularly strength-training exercises.

RESISTANCE TRAINING EXERCISE EFFECTS ON MUSCULAR STRENGTH, ENDURANCE, AND FATS OF LOWER LIMBS IN ADULTS; IT'S FINANCIAL IMPLICATIONS

Purpose: Primary aim of the research study was to develop awareness among the participants about the benefits of exercise and its financial benefits. Methodology: Adults had to perform exercises on Unstable Surfaces (US), Stable Surface (SS) and Machine Based (MB). The protocol of exercises was divided into three categories with 30 participants in each group i.e., Machine Based Surface Resistance Training (M-SRT), Machine Based Unstable Surface Resistance Training (M-URT), and Free Weight Unstable Surfaces Resistance Training (F-URT). Equipment used for tests was imported. Cost of financial expenditure and effects of resistance training exercise protocol on the male adults’ lower limbs muscular power, body fats, and strength were compared. Leg extension strength, leg press, muscle fuel, and body fats were checked on the baseline and after a seven-week resistance training program in the adults and budget, effects took away from the parents. Main Findings: The subjects’ results in maximal resistance training of squad movement were significantly higher in M-SRT and M-URT as compared to F-URT. The average seven-week regular resistance training exercise protocol program in adults with proper supervision will minimize the risk of injury and develop the strength and endurance in the lower limbs of adults up to maximal and that the composition of the body fats was observed lesser. There are training and exercise centres in Dera Ismail Khan city and adults can easily manage to become members of those clubs with nominal registration fees. Fitness and wellbeing are directly associated with the financial benefits of exercise and training. It was observed that the student adults can easily manage the resistance training program for their fitness by curtailing their pocket money. The implication of the Study: The findings of the research study have vital impacts on the daily life routine life of adults. Adults can easily manage to spare some time from leisure and money to keep themselves fit and healthy. The nation needs healthy adults to serve the best and build a nation. The results of analyzed data will help the parents and teachers to motivate their children to participate in the activities of fitness centres and acquaint the adults with financial behaviour change theory. Proper counselling of the experts will be fruitful in light of the recommendations of the study. Novelty: For the first time such a study is going to be conducted in the field of sports and finance. This is primary research in the homeland to highlight the behavioural economics capitalization in sports and training. The financial impacts of training and exercise on the fitness of youth have been studied in length. Future researchers would be benefited from the results of the study and they will be able to include the purchase of basic equipment for exercise and training in the institute budget.