Exercise prescription to improve clinical practice on cancer patients suffering chemotherapy-induced peripheral neuropathy undergoing treatment: a systematic review

This document aims to summarize and analyze systematically the current body of evidence about the effects of specific exercise proto- cols on physical function, balance control and quality of life in patients with peripheral neuropathy (PNP) induced by chemotherapy. Methods: Systematic Review, Literature survey Specific terms were identified for the literature research in MEDLINE, Scopus, Bandolier, PEDro, and Web of Science. Only studies pub- lished in peer-reviewed journals written in English language were considered. Four manuscripts were classified as eligible with 88 total participants, with an average of 57.1 years old. Quality appraisal classified two studies as high quality investigations while two with low quality. Results were summarized in the following domains: \u201cCIPN symptoms\u201d, \u201cStatic balance control\u201d, \u201cDynamic balance control\u201d, \u201cQuali- ty of life and Physical function\u201d. Results Specific exercise protocols were able to counteract common symptoms of chemotherapy-induced peripheral neuropathy (CIPN) during chemotherapy treatments. Significant improvements were detected on postural control. Additionally, patients\u2019 quality of life and inde- pendence were found ameliorated after exercise sessions, together with reductions on altered sensations and in other peripheral neu- ropathy symptoms. Combined exercise protocols including endurance, strength and sensorimotor training showed larger improvements. Conclusions Exercise prescriptions for cancer patients undergoing chemotherapy with CIPN symptoms should be recommended since these exercise interventions appeared as feasible and have been demonstrated as useful tools to counteract some common side effects of chemother- apeutic agents

Differential expression profiles of cell-to-matrix-related molecules in adrenal cortical tumors: Diagnostic and prognostic implications

The molecular mechanisms of adrenocortical carcinoma development are incompletely defined. De-regulation of cellular-to-extracellular matrix interactions and angiogenesis appear among mechanisms associated to the malignant phenotype. Our aim was to investigate, employing PCR-based array profiling, 157 molecules involved in cell-to-matrix interactions and angiogenesis in a frozen series of 6 benign and 6 malignant adrenocortical neoplasms, to identify novel pathogenetic markers. In 14 genes, a significant dysregulation was detected in adrenocortical carcinomas as compared to adenomas, most of them being downregulated. Three exceptions—hyaluronan synthase 1 (HAS-1), laminin α3 and osteopontin genes—demonstrated an increased expression in adrenocortical carcinomas of 4.46, 4.23 and 20.32-fold, respectively, and were validated by immunohistochemistry on a series of paraffin-embedded tissues, including 20 adenomas and 73 carcinomas. Osteopontin protein, absent in all adenomas, was expressed in a carcinoma subset (25/73) (p = 0.0022). Laminin α3 and HAS-1 were mostly expressed in smooth muscle and endothelial cells of the vascular network of both benign and malignant adrenocortical tumors. HAS-1 was also detected in tumor cells, with a more intense pattern in carcinomas. In this group, strong expression was significantly associated with more favorable clinicopathological features. These data demonstrate that cell-to-matrix interactions are specifically altered in adrenocortical carcinoma and identify osteopontin and HAS-1 as novel potential diagnostic and prognostic biomarkers, respectively, in adrenal cortical tumors

Reliability of an isometric and isokinetic strength testing protocol of the knee and ankle in young adults

Background: Isokinetic dynamometers are becoming very common in assessing muscle strength and pathology, both in research and clinical practice, but for most of those devices reliability studies are still needed to support their extended use. The aim of this study is to assess the test-retest reliability also in health adults. Methods: Thirty adults (13 male and 17 females; mean age 25.4 ± 2.7 years) were recruited among University students. They participated to two testing sessions (7 day apart) in which they performed isokinetic and isometric strength assessment of the knee and ankle flexion and extension. Results: All variable showed an Intra-class correlation coefficient higher than 0.7 (isometric knee extension 0.96; isokinetic knee extension 0.96; isokinetic knee flexion 0.97; isometric ankle right flexion pl and flexion do 0.75-0.96; isometric ankle left flexion pl and flexion do 0.78-0.97; isokinetic ankle right flexion pl and flexion do 0.88-0.73; isokinetic ankle right flexion pl and flexion do 0.88-0.85) and paired-sample t-test showed no significant difference. Moreover, most of the recorded values were included within the upper and lower limits of agreement. Conclusion: Multi-joint evaluation system is a reliable device to assess knee and ankle isokinetic and isometric strength among healthy adults

Nordic Walking promoted weight loss in overweight and obese people: A systematic review for future exercise prescription

The aim of this systematic review was to analyze the effect of Nordic Walking (NW) on anthropometric parameters, body composition, cardiovascular parameters, aerobic capacity, blood sample, and glucose tolerance in overweight and obese subjects. The main keywords "Nordic Walking" or "Pole Walking", associated with either "obese", "obesity", "overweight", or "weight loss" were used on the online database MEDLINE, PubMed, SPORTDiscus and Scopus. Additionally, references of the studies included were screened to identify eligible articles. Applying the inclusion and exclusion criteria, ten manuscripts were considered as eligible for this review. The results of the studies were categorized in several domains with regard to "anthropometric parameters and body composition", "cardiovascular parameters and aerobic capacity", and "blood sample and glucose tolerance". The results showed positive effects on the anthropometric parameters, body composition, cardiovascular parameters, blood sample, and glucose tolerance. The greatest improvements were observed in supervised and high weekly frequency of NW interventions. NW could be considered as an effective modality through which to involve the obese in physical activity. For weight loss, NW should be prescribed 4-5 times per week, at least 60 min per session, preferably combined with diet control

The Effect of Exercise Training on Irisin Secretion in Patients with Type 2 Diabetes: A Systematic Review

Introduction: Irisin is a myokine considered to be a potential mediator of exercise-induced energy metabolism and its secretion is known to promote the browning of beige fat cells in white adipose tissue. However, it is currently not known which exercise protocol is the best to enhance irisin concentration in patients with type 2 diabetes (T2D). Objective: The purpose of this study is to provide a review investigating the irisin response to different exercise training modalities and intensities in T2D. Methods: A systematic literature search was performed in May 2022. Results: After the selection process from 938 articles, six studies were included. Selected papers presented different exercise training interventions regarding intensity and modality. One study reported no significant differences in serum irisin levels after exercise training, whereas the other five showed a higher increase in serum irisin levels after exercise training with higher differences in irisin secretion after high-intensity training (HIT). No consideration was possible on exercise modalities. Conclusions: The impact of training intensity and modality was found to be partly discordant but data seem to suggest that HIT promotes greater irisin secretion. Despite the limited evidence, HIT, both in interval and continuous modalities, could be suggested as valid exercise training to increase circulating irisin in patients with T2D

A tailored physical activity intervention and exercise prescription to improve clinical practice for onco-hematology inpatients

Introduction Therapy of hematological malignancies persists for a long time and involves in various complications. The main consequences of chemotherapy are fatigue and forced bed rest, due to immunodeficiency secondary to the treatment that, in turn, also contributes to in impairment of physical efficiency. Physical activity and structure exercise programs can prevent this weakening through the improvement of aerobic capacity and muscle strength, thus this investigation aimed to determine the beneficial role of exercise in the maintenance of the physical function in onco-hematology inpatients. Methods The study included onco-hematology patients, who were administered a tailored exercise protocol during their hospitalization. Interven- tion was mainly focused for the development of strength and flexibility; exercise sessions were directly performed in the patients\u2019 own hospital room. Exercise program was supervised by an Exercise Specialist and driven by audio-video support. Intervention group was compared with control group, which remained physically inactive for all period of hospitalization. Results The intervention group did not show significant decreases during hospitalization period. Significant changes were found in flexibility performance and in balance control (p <0.05). On the contrary, strength had a significant decrease in the control group. Discussion Results from this investigation showed that a tailored exercise protocol administered to hospitalized onco-hematology patients is feasible and efficient to promote the maintenance of their physical function. Moreover, results indicated a beneficial effect of the exercise counter- acting side effects of chemotherapy treatments with a concurrent reduction in bed rest syndrome