Rowing-ramp protocol as a cardiopulmonary exercise test for hemiparetic stroke survivors

Cardiopulmonary capacity should be evaluated accurately to determine exercise intolerance and training intensity of stroke survivors before an exercise rehabilitation programme is prescribed. However, no cardiopulmonary exercise test (CPET) is suitable because of the stroke victims’ physical impairment. The aim of this study was to develop and validate a new rowing-ramp protocol as a CPET for stroke survivors. Eleven stroke patients (6 male; 5 female; age, 45 + 16.01 years, performed two incremental exercise tests on a Concept II rowing ergometer to determine the peak oxygen consumption (VO2 peak). Test-retest reliability for VO2 peak, measured 1-week apart, resulted in an intra-class correlation of 0.97 and 0.95, respectively. A linear regression equation was developed to predict the VO2 peak from final stage stroke power. Validity and reliability of the prediction equation were established. The regression equation for predicted VO2 peak was VO2 peak=11.429±+ 0.232 (Final Stage Stroke Power) + 12.63 (F=25.326, p<0.01; R=0.859, R2=0.738). Limits of agreement between predicted and measured VO2 peak were acceptable, with a mean bias of 0.37 ml/kg/min. The validity coefficient (R) was 0.83 (p<0.01) and 0.81 (p<0.01) in both trials. Test-Retest reliability coefficient for predicted VO2 peak 0.95 (p<0.01). The positive relationship between Final Stage Stroke Power and VO2 peak suggests that the Rowing-Ramp protocol could be used to measure VO2 peak of stroke survivors. Additional studies are needed to cross-validate the regression equation using larger sample size, different type and severity of stroke

Obesity’s Influence on the Psychosocial Wellbeing of Primary School Students in Kota Kinabalu: A Phenomenological Approach

Overweight and obesity among youngsters have grown quickly worldwide in recent decades, including in Malaysia. The major goals of this study are to investigate the psychological impacts that obesity has on children and to find out the quality of life of obese children. A qualitative study design and a phenomenological approach are used in this study. The study used a purposive sampling method. A sample was selected of five obese male and female students aged 11 and 12 years. The selected students attend a government primary school in the city of Kota Kinabalu, Sabah, Malaysia. The data collection process was done using the methods of interviews, observations, and document analysis. Based on the findings of the study, there are three emerging themes that explain the psychological effects experienced by primary school students that impact their quality of life. These include: (a) social health, (b) mental health, and (c) physical health complications. In conclusion, this study found that obesity causes an enormous number of psychosocial problems with regard to the personal and social lives of children. Second, this research informed parents about the prevalence of bullying in the home, perpetrated by siblings. Finally, these findings contribute to the growing body of research revealing the harmful effects of weight-related stigma, even at a young age, and may be valuable in modifying public policy about weight discrimination

Overweight and obese children's psychosocial effects: A review of the literature

Childhood obesity has reached epidemic proportions in both developed and developing nations. Childhood obesity and overweight have been shown to have a negative influence on both physical and psychological health. The goal of this study was to look at the psychological and psychosocial effects of childhood obesity. Obese and overweight children were more likely than their healthy-weight peers to have various related psychosocial issues, which may be affected negatively by childhood obesity stigma, taunting, and bullying. Childhood obesity stigma, taunting, and bullying are widespread and can have significant implications for mental and physical health and performance. Furthermore, childhood obesity can have a significant impact on a child's psychological and emotional well-being, self-esteem, and overall quality of life. To battle the present obesity epidemic, a coherent and comprehensive strategy is required to counteract this rising trend that jeopardises the health and well-being of the next generation

Elemen Beat Dalam Babak Dua : Analisis Filem Polis Evo (2015)

This study reveals the importance of beat elements in the second half of the confrontation in the action movie, "Polis Evo" (2015). The use of beat elements is aimed at increasing the intensity of the scenes which can increase the adrenaline of the audience when watching an action movie. A high and more intense beat in action scenes, for example, will lead to higher levels of emotional excitement and anxiety of the audience. Beat analysis affects the stage intensity of an action movie as demonstrated by Blake Snyder’s (2005) approach which he introduced the beat sheet element. The beat element consists of opening image, theme, set up, catalyst, debate, division, story, fun and games, mid-point, antagonist attack, “all is lost”, “dark night of the soul,” “three parts,” finale and final image. Blake Snyder’s beat element is aimed at making the storytelling more exciting for audiences. Additionally, this article will discuss the style element or movie language used by the director to visualize the scene. Audio styles, shotgun, editing techniques and mise-en-scene aspects will also increase the storytelling intensity of a movie making it more action packed through the narrative structure creating a great action movie to attract the attention of an audience

Elevation of leukocyte counts is associated with an increase in the intensity and duration of exercise

Purpose The aim of this study is to investigate the effect of intensity and duration of exercise related to the leucocyte count. Methods 25 male subjects completed all nine cycling sessions at 55±5 rpm on a cycle ergometer for 10, 20, and 30 min at workloads that corresponded to 50, 60, and 70% of an individual’s pre-determined peak oxygen consumption (V̇ O2peak), in random order. Heart rate and V̇ O2peak were monitored each minute during the exercise to ensure that the subjects were exercising at the given relative intensity. Blood samples were taken before and after the exercise. Results The overall leucocyte counts and its subtypes including lymphocytes, monocytes, and neutrophils were significantly elevated immediately after exercise at all intensity and duration of exercise. ANOVA showed that the main effect of time (T) on leucocyte, neutrophil, lymphocyte, and monocyte counts increases over time. ANOVA analysis also showed that only exercise duration has a significant effect in overall leucocyte counts, including its subtypes. Additionally, this study also revealed that the overall leucocyte counts and its subtypes had a positive correlation with the duration of exercise using Pearson’s correlation coefficient test. However, only lymphocytes were positively correlated (r=0.178) with exercise intensity. Conclusions This study strongly recommends a re-evaluation of current views about the intensity and duration of physical exercise. A precise definition of an individual’s workload that consists of intensity and duration of exercise is crucial as it will affect blood viscosity and blood flow during and immediately after exercise

A Case Report on Core Muscles Training for Knee Osteoarthritis Through Core Muscles Activations and Gait Analysis

Knee osteoarthritis (OA) is a chronic joint disease that can affect all ages, but it is more common in the elderly. Pharmacological and non-pharmacological treatments have been invented evolutionarily over the years to halt this disease. Exercise is one of the first-line treatments for knee OA as well as for prevention. This case study features a 47-year-old man who has grade IV bilateral knee OA and has never had any surgery and takes fish oil daily as a supplement. His walking pattern was significantly impacted by the chronic knee discomfort he had in both legs. Thus, the walking gait of this patient was analyzed together with core muscle activation before and after two weeks of core resistance exercise intervention. The knee pain score was assessed using the Western Ontario and McMaster Universities Index (WOMAC). The outcomes of this research depict that core resistance training has the potential to be used as an alternative, non-surgical and non-pharmacological treatment for a patient with knee OA

Effects of self-management program as adjunctive to usual rehabilitation exercise on pain and functional outcomes in knee osteoarthritis: a randomized controlled trial

Background:Home-basedexercise(HBE)andpatient education (EDU) have been reported asbeneficial additions to usual knee osteoarthritis (KOA) rehabilitation. However, previous trials mostly examined the effects of HBE and EDU separately. Thus, this study aimed to evaluate the effects of a structured combined HBE and EDU program in addition to usual KOA rehabilitation on pain score, functional mobility, and disability level. Study Design: A parallel-group, single-blinded randomized controlled trial. Methods: Eighty adults with KOA were randomly allocated to experimental (n=40) and control (n=40) groups. All participants underwent their usual physiotherapy care weekly for eight weeks. The experimental group received a structured HBE+EDU program to their usual care, while the control group performed home stretching exercises to equate treatment time. The Knee Injury and Osteoarthritis Outcome Score (KOOS) for the disability level, visual analogue scale (VAS) for pain, and timed up-and-go test (TUG) for mobility were measured pre-post intervention. Results: After eight weeks, the experimental group demonstrated significant improvements in the KOOS (all subscales), pain VAS, and TUG scores compared to baseline (P < 0.001); meanwhile, only KOOS (activities of daily living and sports subscales) was significant in the control group. Relative to the control, the experimental group presented higher improvements (P<0.001) by 22.2%, 44.1%, and 15.7% for KOOS, pain VAS, and TUG, respectively. Conclusion: Integrating the HBE+EDU program into usual KOA rehabilitation could reduce pain and disability, while it improved functional mobility. The finding of this study suggests a combination of a structured HBE and EDU program to be considered as part of mainstream KOA management

Bariatric surgery and its impact on fertility, pregnancy and its outcome: a narrative review

Bariatric procedures are on the rise as a surgical treatment for morbid obesity. In reproductive age of women, bariatric surgeries will improve factors related to anovulation and lead to spontaneous fertility. Spontaneous pregnancy can happen within a year after bariatric surgery due to higher level of sex hormone binding globulin and follicular stimulating hormone and reduction in androgens level. Reduction of length of follicular phase of menstrual cycle was reported and contribute to improved ovulatory status. The major impact to pregnant women is development of small for gestational age babies due to persistent weight loss but this can be minimized by avoiding pregnancies too soon after bariatric surgery and good nutrition supplement. Risk of developing gestational diabetes mellitus and preeclampsia reduced among post bariatric surgery compared to no surgery. Another benefit observed are reduction in the risk of caesarean section and admission to neonatal intensive care unit. There are no significant changes in composition of breast milk in postpartum women without bariatric surgery and with women whom undergone surgery although more study needed to evaluate this effect. Good prenatal care, micronutrient supplement during antenatal follow up and close supervision from expert managing this pregnancy are essential component to ensure good outcome to mothers and their newborn

Effects of 12-Week Rowing Training on Resting Cardiac Output, Stroke Volume, and Heart Rate of Stroke Survivors

Rowing exercise is one of the cardiorespiratory exercises that induce higher aerobic capacity. Cardiorespiratory parameters, cardiac output (CO), stroke volume (SV), and heart rate (HR) are indicators to measure one’s cardiorespiratory fitness. The aim was to study the effects of 12-week rowing training on resting cardiac output (RCO), resting stroke volume (RSV), and resting heart rate (RHR) of stroke survivors. Ten stroke survivors (6 males; 4 females), mean age of 43.6 ± 16.15 years, were subjected to a 12-week rowing training (Concept II Rowing Ergometer, Model C, USA). An individualised programme was prescribed based on %HRR for each of stroke individual. Rowing training was conductedtwice per week (12 HIIT; 12 MR). Paired t-test and repeated measures ANOVA (RPM ANOVA) were used for statistical analyses using IBM® SPSS® Statistics 20 software. RPM ANOVA analysis showed no significant effect on RCO [F (5, 45) = 1.066, p = 0.392, RSV [F (2.188, 19.693) = 0.677, p = 0.532)], and RHR [F (5, 45) = 0.856, p = 0.518]. Paired t-test showed no significant difference between pre- and post-test despite the improved values of Mean ± Standard Deviation (RCO: 8129.50 ± 3916.31 to 8494.18 ± 6248.86 mL/min; RSV: 99.27 ± 33.98 to 121.84 ± 66.24 mL; RHR: 78.02 ± 17.39 to 77.17 ± 11.98 bpm) for all respective parameters. Twelve weeks rowing training did not improve resting cardiorespiratory parameters of stroke survivors statistically. Future studies are suggested to include gender difference and medication effect variables

Effect of Core Exercises on Motor Function Recovery in Stroke Survivors with Very Severe Motor Impairment

Paresis of the upper and lower limbs is a typical issue in stroke survivors. This study aims to determine whether core exercises help stroke survivors with very severe motor impairment recover their motor function. This study employed a within-subjects design. Eleven hemiparetic stroke patients with very severe motor impairment (FMA score < 35) and ages ranging from 24 to 52 years old were enrolled in this study. All participants engaged in supervised core exercise training twice a week for 12 weeks. The main outcome measures were Fugl-Meyer Assessment Lower Extremity (FMA-LE) and Fugl-Meyer Assessment Upper Extremity (FMA-UE), which were measured before training and at intervals of four weeks during training. Repeated measures ANOVA was used to analyze the effect of core exercises on motor function performance and lower extremity motor function and upper extremity motor function recovery. There were significant differences in the mean scores for motor function performance, lower extremity motor function, and upper extremity motor function throughout the four time points. A post-hoc pairwise comparison using the Bonferroni correction revealed that mean scores significantly increased and were statistically different between the initial assessment and follow-up assessments four, eight, and twelve weeks later. This study suggests that 12 weeks of core exercise training is effective for improving motor function recovery in patients with very severe motor impairment