L'attività motoria acquatica come nuovo approccio terapico alla cardio-diabetologia

The role of general physical activity on improving cardiometabolic profile and quality of life in patients with type 2 diabetes is widely demonstrated. However, little is known about the effects of specific water exercise program in patients with type 2 diabetes. Therefore, the aims of this pilot study were to evaluated the effects of a supervised water training program in subjects affected by type 2 diabetes. Methods: eighteen men affected by type 2 diabetes (51,4±9,38 years), were enrolled in a program of 12 weeks of supervised water training. We assess Cardiometabolic Profile (echocardiography, glycemic, lipidemic and anthropometric profille, blood pressure levels and cardiopulmonary exercise test), and Quality of Life and Physical Activity Levels (Short-form Health Survey 36 with items (SF-36), Problem Areas in Diabetes Questionnaire (PAID) and International Physical Activity Questionnaire (IPAQ)) before and after 12-weeks of a supervised water exercise program. Results: The results showed a significant improvement of cardiovascular and metabolic assessments (aerobic capacity, work, blood pressure, glycemic, anthropometric and lipidemic profile, and diastolic function) and an increasing in quality of life and physical activity levels (Sf-36, PAID, energy expenditure in general physical activity). Discussion: Our findings showed that structured and supervised physical activity performed in water, produced benefits both in improving of the cardiometabolic profile and the HRQoL and also in increasing of the physical activity levels in subjects affected by type 2 diabetes

Conventional exercise interventions for adults with intellectual disabilities: A systematic review and meta-analysis

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L'attività motoria acquatica come nuovo approccio terapico alla cardio-diabetologia

The role of general physical activity on improving cardiometabolic profile and quality of life in patients with type 2 diabetes is widely demonstrated. However, little is known about the effects of specific water exercise program in patients with type 2 diabetes. Therefore, the aims of this pilot study were to evaluated the effects of a supervised water training program in subjects affected by type 2 diabetes. Methods: eighteen men affected by type 2 diabetes (51,4±9,38 years), were enrolled in a program of 12 weeks of supervised water training. We assess Cardiometabolic Profile (echocardiography, glycemic, lipidemic and anthropometric profille, blood pressure levels and cardiopulmonary exercise test), and Quality of Life and Physical Activity Levels (Short-form Health Survey 36 with items (SF-36), Problem Areas in Diabetes Questionnaire (PAID) and International Physical Activity Questionnaire (IPAQ)) before and after 12-weeks of a supervised water exercise program. Results: The results showed a significant improvement of cardiovascular and metabolic assessments (aerobic capacity, work, blood pressure, glycemic, anthropometric and lipidemic profile, and diastolic function) and an increasing in quality of life and physical activity levels (Sf-36, PAID, energy expenditure in general physical activity). Discussion: Our findings showed that structured and supervised physical activity performed in water, produced benefits both in improving of the cardiometabolic profile and the HRQoL and also in increasing of the physical activity levels in subjects affected by type 2 diabetes

Effects of metformin and exercise training, alone or in association, on cardio-pulmonary performance and quality of life in insulin resistance patients

BACKGROUND: Metformin (MET) therapy exerts positive effects improving glucose tolerance and preventing the evolution toward diabetes in insulin resistant patients. It has been shown that adding MET to exercise training does not improve insulin sensitivity. The aim of this study was to determine the effect of MET and exercise training alone or in combination on maximal aerobic capacity and, as a secondary end-point on quality of life indexes in individuals with insulin resistance. METHODS: 75 insulin resistant patients were enrolled and subsequently assigned to MET (M), MET with exercise training (MEx), and exercise training alone (Ex). 12-weeks of supervised exercise-training program was carried out in both Ex and MEx groups. Cardiopulmonary exercise test and SF-36 to evaluate Health-Related Quality of Life (HRQoL) was performed at basal and after 12-weeks of treatment. RESULTS: Cardiopulmonary exercise test showed a significant increase of peak VO2 in Ex and MEx whereas M showed no improvement of peak VO2 (∆ VO2 [CI 95%] Ex +0.26 [0.47 to 0.05] l/min; ∆ VO2 MEx +0.19 [0.33 to 0.05] l/min; ∆ VO2 M -0.09 [-0.03 to -0.15] l/min; M vs E p < 0.01; M vs MEx p < 0.01; MEx vs Ex p = ns). SF-36 highlighted a significant increase in general QoL index in the MEx (58.3 ± 19 vs 77.3 ± 16; p < 0.01) and Ex (62.1 ± 17 vs 73.7 ± 12; p < 0.005) groups. CONCLUSIONS: We evidenced that cardiopulmonary negative effects showed by MET therapy may be counterbalanced with the combination of exercise training. Given that exercise training associated with MET produced similar effects to exercise training alone in terms of maximal aerobic capacity and HRQoL, programmed exercise training remains the first choice therapy in insulin resistant patients

Nordic Walking can be incorporated in the exercise prescription to increase aerobic capacity, strength and quality of life for elderly: a systematic review and meta-analysis.

Abstract The aim of this systematic review and meta-analysis was to summarize and analyze the effects of Nordic Walking on physical fitness, body composition and quality of life in the elderly. METHODS: keyword "Nordic Walking" associated with "elderly" AND/OR "aging" AND/OR "old subjects" AND/OR "aged" AND/OR "older adults" were used in the onlines database Medline, Embase, PubMed, Scopus, PsycINFO and SPORTDiscus. Only studies written in English language and published in peer-reviewed journals were considered. A meta-analysis was performed and effect sizes calculated. RESULTS: 15 studies were identified; age of participants ranged from 60 to 92 years old. Comparing with a sedentary group, effect sizes showed that Nordic Walking was able to improve dynamic balance (0.30), functional balance (0.62), muscle strength of upper (0.66) and lower limbs (0.43), aerobic capacity (0.92), cardiovascular outcomes (0.23), body composition (0.30) and lipid profile (0.67). It seemed that Nordic Walking had a negative effect on static balance (-0.72). Comparing with a walking (alone) training, effect sizes showed that Nordic Walking improved the dynamic balance (0.30), flexibility of the lower body (0.47) and quality of life (0.53). Walking training was more effective in improving aerobic capacity (-0.21). Comparing Nordic Walking with resistance training, effect sizes showed that Nordic Walking improved dynamic balance (0.33), muscle strength of the lower body (0.39), aerobic capacity (0.75), flexibility of the upper body (0.41), and the quality of life (0.93). CONCLUSIONS: Nordic Walking can be considered as a safe and accessible form of aerobic exercise for the elderly population, able to improve cardiovascular outcomes, muscle strength, balance ability and quality of life

Effects of metformin and exercise training, alone or in combination, on cardiac function in individuals with insulin resistance

Introduction: In patients affected by insulin resistance (IR), metformin (MET) therapy has been shown to exert its positive effects by improving glucose tolerance and preventing the evolution to diabetes. Recently, it was shown that the addition of metformin to physical training did not improve sensitivity to insulin or peak oxygen consumption (peak VO2). The purpose of this study was to establish the effect of metformin and exercise, separately or in combination, on systolic left ventricular (LV) function in individuals with IR. Methods: Seventy-five patients with IR were enrolled and subsequently assigned to MET, combination MET and exercise, or exercise alone. The LV systolic and diastolic functions were evaluated with standard echocardiography tissue Doppler imaging (TDI) and speckle tracking echocardiography at baseline and after 12 weeks of treatment. Results: MET, administered alone or in association with exercise, improved longitudinal LV function, as evidenced by an increase in systolic (S) wave on TDI, alongside increases in longitudinal global strain and strain rate in comparison to the group undergoing physical training alone. The traditional echocardiographic parameters showed no statistically significant differences among the three groups before or after the different cycles of therapy. Conclusions: Treatment with MET, either with or without exercise, but not exercise alone, produced a significant increase in global longitudinal LV systolic function at rest. These findings validate the observation that the use of MET alone or in association with exercise has a crucial role to counteract the negative effects of IR on cardiovascular function

Gender differences and cardiometabolic risk. the importance of the risk factors

Metabolic syndrome (Mets) is a clinical condition characterized by a cluster of major risk factors for cardiovascular disease (CVD) and type 2 diabetes: proatherogenic dyslipidemia, elevated blood pressure, dysglycemia, and abdominal obesity. Each risk factor has an independent effect, but, when aggregated, they become synergistic, doubling the risk of developing cardiovascular diseases and causing a 1.5-fold increase in all-cause mortality. We will highlight gender differences in the epidemiology, etiology, pathophysiology, and clinical expression of the aforementioned Mets components. Moreover, we will discuss gender differences in new biochemical markers of metabolic syndrome and cardiovascular risk

Cardiovascular Risk Perception and Knowledge among Italian Women: Lessons from IGENDA Protocol

A multicenter, cross-sectional observational study (Italian GENder Differences in Awareness of Cardiovascular risk, IGENDA study) was carried out to evaluate the perception and knowledge of cardiovascular risk among Italian women. An anonymous questionnaire was completed by 4454 women (44.3 ± 14.1 years). The 70% of respondents correctly identified cardiovascular disease (CVD) as the leading cause of death. More than half of respondents quoted cancer as the greatest current and future health problem of women of same age. Sixty percent of interviewed women considered CVD as an almost exclusively male condition. Although respondents showed a good knowledge of the major cardiovascular risk factors, the presence of cardiovascular risk factors was not associated with higher odds of identifying CVD as the biggest cause of death. Less than 10% of respondents perceived themselves as being at high CVD risk, and the increased CVD risk perception was associated with ageing, higher frequency of cardiovascular risk factors and disease, and a poorer self-rated health status. The findings of this study highlight the low perception of cardiovascular risk in Italian women and suggest an urgent need to enhance knowledge and perception of CVD risk in women as a real health problem and not just as a as a life-threatening threat

Flexibility and Strength Effects of Adapted Nordic Walking and Myofascial Exercises Practice in Breast Cancer Survivors and Analysis of Differences

Breast cancer treatments can elicit negative kinesiological side effects concerning both the posture and functional status of breast cancer survivors. As our body is functionally organized in myofascial meridians, physical exercise practice should favor a whole-body approach rather than a local one. The aim of the study was to investigate and compare the effects of two whole-body disciplines, i.e., adapted Nordic Walking and myofascial exercise, on the flexibility and strength performances in BCS. One hundred and sixty breast cancer survivors were trained three times per week for 12 weeks through adapted Nordic Walking or myofascial exercise. Handgrip, sit and reach, back scratch, and single leg back bridge tests and body composition were assessed at the beginning and completion of the training period. Linear mixed models showed no significant changes in body composition, whereas flexibility (p &lt; 0.001), strength (p &lt; 0.001), and muscle quality index (p = 0.003) changed independently from the treatment. When data modification has been analyzed according to sub-sample membership, no significant differences have been observed. Age, radiation therapy, and chemotherapy seem to have independent effects on several investigated variables. Twelve weeks of adapted myofascial exercise and Nordic Walking led to significant changes in flexibility, strength, and muscle quality in breast cancer survivors, with no apparent superiority of one approach over the other