Effects of a home-based physical training and activity promotion program in community-dwelling older persons with cognitive impairment after discharge from rehabilitation: A randomized controlled trial

Background Older people with cognitive impairment (CI) are at high risk for mobility limitations and adverse outcomes after discharge from geriatric rehabilitation settings. Study aim was to estimate the effects of a specifically designed home-based physical training and activity promotion program on physical capacity, different aspects of physical activity (PA), and psychosocial status. Methods Patients with mild-to-moderate CI (Mini-Mental State Examination [MMSE]: 17-26 points) discharged home after rehabilitation were included in this randomized, double-blind, placebo-controlled trial with a 12-week intervention and 12-week follow-up period. The intervention group performed a CI-specific, autonomous, home-based strength, balance and walking training supported by tailored motivational strategies to foster training adherence and promote PA. The control group participated in an unspecific motor placebo activity. Primary outcomes were physical capacity (Short Physical Performance Battery [SPPB]) and PA (sensor-based activity time). Results Among 118 randomized participants (82.3±6.0 years) with CI (MMSE: 23.3±2.4) and high levels of multi-morbidity, those participants undergoing home-based training demonstrated superior outcomes to the control group in SPPB (mean difference between groups 1.9 points; 95%-CI: 1.0-2.8; p<.001), with persistent benefits over the follow-up (1.3 points; 95%-CI: 0.4-2.2; p<.001). There were no differences in PA across any time points. Among secondary outcomes, fear of falling and activity avoidance behavior were reduced in the intervention group at all time points, life-space mobility improved short-term. Conclusions Study results demonstrate clinically important benefits of an individually tailored autonomous physical training and activity promotion program on physical capacity and secondary outcomes in different domains in a vulnerable, multi-morbid population.

Body composition, physical capacity, and immuno-metabolic profile in community-acquired pneumonia caused by COVID-19, influenza, and bacteria: a prospective cohort study

Background Different pathogens can cause community-acquired pneumonia (CAP); however, the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has re-emphasized the vital role of respiratory viruses as a cause of CAP. The aim was to explore differences in metabolic profile, body composition, physical capacity, and inflammation between patients hospitalized with CAP caused by different etiology. Methods A prospective study of Danish patients hospitalized with CAP caused by SARS-CoV-2, influenza, or bacteria. Fat (FM) and fat-free mass (FFM) were assessed with bioelectrical impedance analysis. Physical activity and capacity were assessed using questionnaires and handgrip strength. Plasma (p)-glucose, p-lipids, hemoglobin A1c (HbA1c), p-adiponectin, and cytokines were measured. Results Among 164 patients with CAP, etiology did not affect admission levels of glucose, HbA1c, adiponectin, or lipids. Overall, 15.2% had known diabetes, 6.1% had undiagnosed diabetes, 51.3% had pre-diabetes, 81% had hyperglycemia, and 60% had low HDL-cholesterol, with no difference between groups. Body mass index, FM, and FFM were similar between groups, with 73% of the patients being characterized with abdominal obesity, although waist circumference was lower in patients with COVID-19. Physical capacity was similar between groups. More than 80% had low handgrip strength and low physical activity levels. Compared to patients with influenza, patients with COVID-19 had increased levels of interferon (IFN)-γ (mean difference (MD) 4.14; 95% CI 1.36–12.58; p = 0.008), interleukin (IL)-4 (MD 1.82; 95% CI 1.12–2.97; p = 0.012), IL-5 (MD 2.22; 95% CI 1.09–4.52; p = 0.024), and IL-6 (MD 2.41; 95% CI 1.02–5.68; p = 0.044) and increased IFN-γ (MD 6.10; 95% CI 2.53–14.71; p < 0.001) and IL-10 (MD 2.68; 95% CI 1.53–4.69; p < 0.001) compared to patients with bacterial CAP, but no difference in IL-1β, tumor necrosis factor-α, IL-8, IL-18, IL-12p70, C-reactive protein, and adiponectin. Conclusion Despite higher inflammatory response in patients with COVID-19, metabolic profile, body composition, and physical capacity were similar to patients with influenza and bacterial CAP.

Necessity of Structured Exercise Training Program and Its Feasability on Physical Capacity and Health Statuswith Post COVID-19 Syndrome Patients

Corona virus Disease 2019 (COVID-19) has spread worldwide and has become a global public health emergency. The World Health Organization declared the outbreak a pandemic. Pulmonary Rehabilitation has shown good impact on Quality of life , Functional capacity and health status of patients with Chronic Respiratory Disease Recently there are various guidelines and consensus available for Pulmonary Rehabilitation in Post – COVID patients that has been extrapolated from other respiratory condition. There is paucity of literature that has shown the effect of Exercise training program on Physical capacity and Health status of patient with Post COVID 19 syndrome. So the present study uses the available evidence on COVID 19 patients to prepare the exercise program and implement it on post COVID syndrome patients.Thus, the aim of this study is to evaluate the effect of supervised Exercise Training Program on Post COVID-19 syndrome patients Methodology: In this experimental study total 70 patients with Post Covid Syndrome will be included and they will be equally divided into two groups. Group A will receive supervised exercise training, while Group B will receive unsupervised exercise training. Participant will be evaluated at the beginning of therapy or after 6 weeks. Discussion: This study is conducted to evaluate effectiveness of structured exercise training program and its feasibility on physical capacity and health status of patients with Post COVID19 syndrome. Conclusion: Its effectiveness of a structured exercise program and its feasibility on physical capacity and health status of patients with Post COVID19 syndrome will be evaluated.

Residential Environment, Depressive Symptoms, and Anxiety Symptoms Among Community-Living Older Adults

Past literature has suggested significant relationships between neighborhood environment and mental health of older adults. However, the effect of residential environments is underexplored. The present study aims to study: (Q1) how residential built environments are associated with depressive and anxiety symptoms among community-living older adults, and (Q2) whether the associations of their physical and cognitive health status with mental health vary by residential environments. We analyzed data from Round 9 of National Health and Aging Trends Study. Residential environments were indicated by home despair, cluttered home, and existence of entrance ramp. Covariates included age, gender, race, living arrangement, ADL limitations, physical capacity, and cognitive status. The logistic regression results show that higher levels of clutter at home and the lack of entrance ramp were significantly associated with more depressive symptoms and that levels of clutter were positively associated with anxiety symptoms. Residential environments significantly moderated the association between physical health and mental health. With similar physical capacity, older adults with higher levels of home despair and clutter had more depressive and anxiety symptoms. Older adults who had more cluttered home reported significantly higher levels of anxiety than those who had similar ADL limitations, but lived in a less cluttered housing environment. However, we didn’t find any moderating effect of residential environments on cognitive impairment and mental health. Our findings promote the necessity for practitioners and policymakers to consider the effect of residential environments on mental health among both physically healthy and impaired older adults in the United States.

Physical capacity, subjective health, and life satisfaction in older women: a 10-year follow-up study

Background Physical capacity and subjective wellbeing are important for healthy aging. Our aim was to study how objective/subjective physical capacity and subjective health relate to life satisfaction, in a 10-year follow-up of aging women. Methods The participants (n = 1485, mean age 67.4 years) consisted of community-dwelling older women living in Kuopio, Finland. Grip strength and one-legged stance test time were used as objective, and self-rated mobility (SRM) as subjective physical capacity measures. Self-rated health (SRH) and SRM were assessed with one-item scales and life satisfaction with a 4-item scale. Correlation and linear regression were used to analyze these relationships and correlation network analysis to visualize them. Age and BMI were included in the analysis as adjusting factors. Results All the study variables were significantly correlated with baseline and follow-up life satisfaction, except BMI, which was only associated with life satisfaction at follow-up. On both occasions, SRH and SRM were the two strongest correlates of life satisfaction, but their mutual correlation was still higher. In linear regression analyses, SRH was positively associated with both baseline and follow-up life satisfaction, but physical capacity measures became non-significant after including SRH and SRM in the model. In the partial correlation network analyses, SRH and SRM were the most central nodes, connecting every other variable. Conclusions Self-reports on health, mobility, and life satisfaction are closely intertwined and provide easily accessible health information among aging women, but the impacts of objective physical capacity measures warrant further longitudinal studies in respect to subjective wellbeing among aging people.

RELATIONSHIP BETWEEN NUTRITION INTAKE AND THE FITNESS OF MANUFACTURING WORKERS IN INDONESIA

ABSTRACKIndonesia ranks fourth in the world out of 15 countries whose manufacturing industries contribute more than 10% to the Gross Domestic Product (GDP). Nowadays, one of the consequences of the rapid development of the manufacturing industry in Indonesia is related to work productivity. Each person's work productivity is not the same, one of them depends on the availability of nutrients in the body. Lack of nutritional consumption for someone from standard needs will affect health conditions, activities, and work productivity. Nutritional substances in workers also affect fitness in addition to other factors such as age, health status, nutritional status, nutritional status, gender, and psychological conditions. Based on the description above, it is necessary to study the relationship between nutritional status and physical fitness of workers in manufacturing companies in Indonesia. The study was cross sectional on 120 workers from 6 manufacturing companies in Indonesia which was conducted using cluster sampling. Assessment of individual characteristics was conducted by direct interview. Assessment of nutritional intake uses the Food Frequency Questionnaire (FFQ) and the results were categorized as appropriate and inappropriate based on the 2019 nutritional adequacy figure for the Indonesian population. The fitness assessment (physical capacity) used a six-minute walking test by an occupational specialist and was converted to Meters and categorized with a cut off of 4.5 Mets to be sufficient or insufficient. About one third of manufacturing workers were centrally obese. Characteristics The dietary intake according to the recommendation were only about 10%, namely the appropriate carbohydrate intake 11.7% (Frequency 8.46 times (533.22 gr)), suitable fat 12.5% (Frequency 2.75 times (57.14 gr)), and suitable protein 10% (Frequency 6.55 times (101.77 gr)). The physical capacity of manufacturing workers in Indonesia was categorized as sufficient as much as 75.8% of their workload. Factors that affect physical capacity, namely age ≥ 40 years have 4.37 times less physical capacity and protein intake affected physical capacity / fitness for workers (p = 0.02). About a third of manufacturing workers were centrally obese. The characteristic of food intake in accordance with the recommended nutritional adequacy of the Indonesian population was only about 10%. The physical capacity of manufacturing workers in Indonesia was categorized as sufficient as much as 75.8% of their workload. Factors that affected physical capacity were age and protein intake. Keywords: Food Intake, Food Frequency Questionnaire (FFQ), Manufacturing Worker, Fitness, Six-Minute Walking Test.

A Methodology for the Definition of the Acoustic Capacity of a Road Infrastructure

In this paper, a new methodology for the assessment of the so-called “acoustic capacity” of a road infrastructure is proposed. This aspect is very important in the field of transportation planning as, currently, road infrastructures are verified only in terms of physical capacity; at most, the environmental capacity due to atmospheric pollutants is taken into account, while the acoustic capacity is completely neglected. The acoustic capacity is assessed based on the Harmonoise model, which is widely recognized at the European level. The Harmonoise model, starting from traffic data, such as traffic flows, average speed, and typologies of vehicles, provides the levels of noise emissions and immissions, which can be compared to the noise limit levels established by law. The validity of the proposed methodology was assessed on a test network. The results of this analysis show that, generally, the acoustic capacity is actually a capacity constraint, which involves several traffic flows: this occurs in particular in the case of an intersection, but also in the case of a bi-directional road. Furthermore, the acoustic capacity of a road infrastructure is generally lower than its physical capacity.

The “can do, do do” concept in individuals with chronic obstructive pulmonary disease: an exploration of psychological mechanisms

Background The “can do, do do” concept aims at identifying subgroups among persons with chronic obstructive pulmonary disease (COPD). Following a two-dimensional categorization, individuals are binarily classified with respect to their levels of physical capacity (“can’t do” or “can do”) and physical activity (“don’t do” or “do do”), resulting in four disjunct quadrants. The approach has been debated recently and the latest articles have concluded that the quadrants should be specifically examined in terms of psychological aspects of physical activity. Therefore, the goal of the present study was to explore the role of psychological variables in physical activity in the context of the “can do, do do” quadrant concept. Methods Within the scope of secondary data analyses of the “Stay Active After Rehabilitation” (STAR) randomized controlled trial, a total of 298 COPD rehabilitants of an inpatient pulmonary rehabilitation program were grouped into the suggested quadrants. We set fixed cut-offs at 70% of relative 6-min walking test performances for healthy individuals (physical capacity dimension) and 5.000 steps per day (physical activity dimension). Univariate and multivariate logistic regression analyses served to analyze whether depression scores, fear avoidance behaviors, disease-specific anxiety, self-concordance for physical activity, and five indicators of physical activity-related health competence (PAHCO) effectively discriminated between the “don’t do” and “do do” groups. Results Among persons with lower relative physical capacity, depression scores, fear avoidance behaviors, and disease-specific anxiety (univariate case) significantly differentiated between the more and the less active. Among persons with higher relative physical capacity, fear avoidance behaviors, disease-specific anxiety, as well as three PAHCO indicators (physical activity-specific self-efficacy, self-control, and affect regulation) significantly separated the more and the less active. In multivariate analyses, only fear avoidance behaviors and affect regulation discriminated among individuals with better relative physical capacity. Conclusion The findings identified important psychological and competence-oriented variables that explain discrepancies in the quadrant concept. Based on this, we discuss implications for physical activity promotion in individuals with COPD. Respiratory research can benefit from future studies complementing the quadrant concept through further behavioral analyses. Trial registration Clinicaltrials.gov, ID: NCT02966561. Registered 17 November, 2016, https://clinicaltrials.gov/ct2/show/NCT02966561.