The Effects of Caloric Restriction and/or Intermittent Fasting on Bone Health

This mini-review summarizes the available information regarding the impact of caloric restriction (CR) and/or intermittent fasting (IF) on bone health. CR and IF are dietary interventions used in rehabilitative healthcare for augmenting weight loss and also proposed for recovery of conditions such as stroke and heart failure. CR restricts the total number of calories rather than different food groups or periods of eating. In contrast, IF severely restricts caloric intake for a period of time followed by a period of ad libitum intake. Here, we discuss the available information regarding the impact of these rehabilitation diets on bone metabolism, highlighting areas of consistency and discrepancy and suggesting future areas of study to advance the understanding of CR and/or IF on bone health.

Validation of the Comprehensive Arm Prosthesis and Rehabilitation Outcomes Questionnaire

Purpose: To develop and psychometrically evaluate the Comprehensive Arm Prosthesis and Rehabilitation Outcomes Questionnaire (CAPROQ), a 28-item, self-report measure of three key facets associated with successful rehabilitation (perceived function, satisfaction, and pain) designed specifically for the adult upper limb loss (ULL) population. Materials and Methods: Using a national sample of adult ULL patients (N=240), factor structure, internal consistency, convergent/concurrent validity, and known group validity of the total CAPROQ score and three subscale scores were evaluated. Results: Confirmatory factor analysis indicated adequate-to-strong factor loading on each subscale: satisfaction (.623-.913), perceived function (.572-.860) and pain (.422-.834). Internal consistencies for the total measure and measure subscales were good-to-excellent (.89-.95) and convergent validity indicated moderate-to-strong statistically significant associations between the CAPROQ subscales and relevant measures. Concurrent validity showed moderate associations between CAPROQ total score, prosthetic wear time, and psychosocial adjustment scores. Known group validity indicated significant differences on CAPROQ total score between initial and definitive fitting stages (p=.012). Conclusion: Psychometric evaluation indicated that the CAPROQ and CAPROQ subscales were structurally sound, internally consistent, and demonstrated convergent validity with currently used assessments of perceived functioning, satisfaction, and pain. CAPROQ is needed for guiding individual patient care, improving care models and future prosthesis selection and development.

A call for research on soft tissue manipulation (STM) as a bone anabolic therapy

Individuals with osteoporosis, i.e., low bone mass, are at enhanced risk for fracture, disability, and death. Hospitalizations for osteoporotic fractures exceed those for heart attack, stroke, and breast cancer. Osteoporosis rates are predicted to increase due to an aging global population yet there are limited pharmacological treatment options for osteoporosis, particularly for long-term management of this chronic condition. Moreover, the drug development pipeline is relatively bereft of new strategies and drug candidates, creating an urgent need for developing new therapeutic strategies for treating osteoporosis. In this mini-review, we speculate about the potential for non-invasive soft tissue manipulation (STM) to exert anabolic effects on the skeleton that may provide therapeutic benefit for individuals with low bone mass. Our rationale is premised on work by us and others showing that STM leads to decreased levels of chemokines and pro-inflammatory cytokines (such as Interleukin (IL)-3, IL-6, and IL-8) known to restrict the differentiation and/or activity of bone-forming osteoblasts. However, there are no published studies examining whether STM impacts bone mass, potentially limiting the widespread use of this non-invasive and non-pharmacological intervention in the worldwide treatment of patients with osteoporosis, individuals with low bone mass due to being bed-ridden or otherwise mobility-limited, and persons subjected to spaceflight-related bone loss.

The association between sarcopenia and the physical function of patients with stroke: A systematic review and meta-analysis

Objectives: The purpose of this study is to identify whether there is an association between sarcopenia and physical function outcomes of patients with stroke. Methods: A systematic search of Pubmed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang database was conducted to identify studies in Chinese and English from the inception of the database to March 2021. Documents were checked for relevancy. Articles exploring the association between sarcopenia and the physical function of patients with stroke were included. The quality of the literature was evaluated using the Newcastle-Ottawa scale tool. Stata 15.0 software was used to conduct meta-analysis. Results: Eight studies met the criteria for inclusion. A meta-analysis of four studies showed that sarcopenia was related to an increased risk of poor physical function of patients with stroke (total OR=3.11, 95% CI: 2.22-4.34, P<0.0001). Descriptive analysis was performed in the rest of studies. Overall, a correlation between the two factors was found in patients with stroke. Some studies suggested a difference based on gender and severity of the disease condition. The studies included in this review were of high methodological quality. The Egger's test (P=0.217) showed no publication bias. Conclusions: This review concludes that sarcopenia is an independent predictive factor of physical function of patients with stroke. Clinicians should pay attention to gender differences and severity of disease condition. Therefore, screening, diagnosis, treatment, and prevention of sarcopenia should be part of the routine clinical practice when providing care to stroke patients.

https://www.rehabiljournal.com/articles/pulmonary-rehabilitation-exercise-assessments-and-training-methods-for-patients-with-copd-a-literature-review.html

Pulmonary rehabilitation (PR) is an important part of the management of COPD, which can reduce symptoms of dyspnea, times of hospitalizations, and improve exercise capacity and health-related quality of patients. As a key element of PR, PR exercise training consists of exercise assessment and training methods. Exercise assessments should include the evaluation of dyspnea, exercise capacity, and health-related quality of life. Following a thorough assessment of patients, individualized exercise training programs, including endurance, resistance, and other exercise training methods, should be developed based on physiologic requirements and individual demands of patients. Although there have been many studies on the types of exercise for patients with COPD, there are still no conclusions about how to develop the best exercise prescription. Choosing the most appropriate methods for patients with COPD to calculate the situation is crucial. Therefore, this review aims to summarize the common methods of exercise assessments and exercise trainings in PR.