A randomized controlled trial to establish the impact of aquatic exercise training on functional capacity, balance, and perceptions of fatigue in female patients with multiple sclerosis

Objective: To assess the effects of 8-weeks aquatic exercise training on functional capacity, balance, and perceptions of fatigue in women with multiple sclerosis (MS). Design: A randomized controlled design. Setting: Referral center of a multiple sclerosis society. Participants: Women (age:36.4 ±8.2; BMI:24.5 ±1.9) diagnosed with RR-type (relapsing-remitting) MS. After undergoing baseline testing, participants were allocated to either an intervention (aquatic training programme) or a control group. Interventions: The intervention consisted of an 8-week aquatic training programme (3 supervised training sessions per week; session duration; 45-60 min; 50-75% heart rate reserve). Main measures: Six-minute walk test (6-MWT); balance (Berg Balance Scale; BBS), and perceptions of fatigue (Modified Fatigue Impact Scale; MFIS), at baseline and after an 8 week intervention. Differences over time between the experimental and control groups were assessed by a 2x2 (group by time) repeated measures analysis of variance (ANOVA). Results: 32 women (age:36.4 ±8.2; BMI:24.5 ±1.9) completed the 8-week aquatic training intervention (experimental group, n=17; controls, n = 15). All outcome measures improved in the experimental group; 6-MWT performance (451±58 m to 503±57 m; P<0.001); BBS (pre-test mean, 53.59±1.70; post-test mean, 55.18±1.18; P<0.001), and in the MFIS (pre-test mean, 43.1±14.6, post-test mean, 32.8 ±5.9;P<0.01). A significant group-by-time interaction was evident between the experimental and controls groups for 6-MWT:P<0.001, ηp²=0.551; BBS:P<0.001, ηp²=0.423; and MFIS: P<0.001, ηp²=0.679. Conclusions: Aquatic exercise training improves functional capacity, balance, and perceptions of fatigue in women with MS

The Prevalence and Characteristics of Performance-Enhancing Drug Use Among Bodybuilding Athletes in the South of Iran, Bushehr

Background: Several reports have implied progressive increase of performance-enhancing drug (PED) use among Iranian athletes. More importantly, most of the previous research in the Iranian population had mainly focused on the anabolic steroid abuse, and ignored other agents. Objectives: The aim of this study was to investigate the prevalence and characteristics of PED use among bodybuilding athletes in Bushehr, south of Iran. Methods: Four hundred and fifty three male bodybuilding athletes were recruited from Bushehr gyms between February and May of 2015. Men were eligible to participate in the survey if they had regularly participated in the strength-training exercise (minimum of 1 year and 4 hour/week). Data were collected via a face-to-face interview. The survey consisted of three separate parts including demographic data, exercise pattern and PED use. Results: According to this study, 234 (51.7%) of bodybuilding athletes had used PEDs. The PED users reported an average of 3.80 � 4.52 agents’ use in their programs and they had used PEDs for the average of 3.24 � 3.99 years. The most prevalent agents which had been abused by the athletes were anabolic steroids (used by 185 athletes (79.4% of athletes). Furthermore, 110 (47%) of athletes reported stimulant agents’ use during their routines. The most prevalent motivation for using PEDs was increasing muscle mass that was reported by 164 (70.1%) of PED users. In addition, sexual and dermatologic effects were the most prevalent adverse effects reported by the PED user athletes (114 (49.4%) and 103 (44.2%), respectively). Conclusions: This study showed the high rate of PED use among recreational and professional Iranian bodybuilding athletes that can expose them to the serious side effects of these agents

Can cardiac rehabilitation programs improve functional capacity and left ventricular diastolic function in patients with mechanical reperfusion after ST elevation myocardial infarction?: A double-blind clinical trial

BACKGROUND: Current guidelines recommend cardiac rehabilitation programs (CRP) as a means to improve functional status of patients after coronary revascularization. However, research supporting this recommendation has been limited and positive effects of CRP on diastolic function are controversial. The aim of this study was to examine the effects of an 8-week CRP on left ventricular diastolic function. METHODS: This randomized, clinical trial included 29 men with ST elevation myocardial infarction (MI) who had received reperfusion therapy, i.e. coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). They were randomized to a training group (n = 15; mean age: 54.2 ± 9.04 years old) and a control group (n = 14; mean age: 51.71 ± 6.98 years old). Patients in the training group performed an 8-week CRP with an intensity of 60-85 of maximum heart rate. Exercise sessions lasted 60-90 minutes and were held three times a week. At the start and end of the study, all patients performed symptom-limited exercise test based on Naughton treadmill protocol. Pulsed-wave Doppler echocardiography was also used to determine peak velocity of early (E) and late (A) waves, E/A ratios, and the deceleration time of E (DT). RESULTS: Left ventricular diastolic indices (E, A, E/A ratio, DT) did not change significantly after the CRP. Compared to baseline, patients in the training group had significant improvements in functional capacity (8.30 ± 1.30 vs. 9.7 ± 1.7) and maximum heart rate (118.50 ± 24.48 vs. 126.85 ± 22.75). Moreover, resting heart rate of the training group was significantly better than the control group at the end of the study (75.36 ± 7.94 vs. 79.80 ± 7.67; P < 0.001). CONCLUSION: An 8-week CRP in post-MI patients revascularized with PCI or CABG led to improved exercise capacity. However, the CRP failed to enhance diastolic function

Effects of a cardiac rehabilitation program on left ventricular systolic function and mass in patient after myocardial infarction

Background: The positive effects of cardiac rehabilitation programs (CRPs) on cardiovascular patients have been demonstrated. However, their effectiveness in improving systolic function and preventing remodeling process needs to be further evaluated. The aim of this study was to examine the effects of an 8-week CRP on left ventricular systolic function and mass in patients after myocardial infarction. Methods: A total number of 29 male patients with myocardial infarction were allocated into cardiac training group (n = 15; mean age = 54.2 ±9.04 years) and control group (n = 14; mean age = 51.71 ± 6.98 years). Patients in the training group performed an 8-week CRP with an intensity of 60-85 of maximum heart rate. The program was performed 3 times a week and each session lasted 60 minutes. Before the CRP and at the end of the study, all patients underwent 2-dimentional echocardiography for left ventricular systolic function and mass to be assessed. Findings: Our findings showed that the 8-week CRP improved left ventricular systolic function in the patients. At the end of the CRP, left ventricular end diastolic dimension increased in the control group. On the other hand, end diastolic volume and end systolic volume decreased significantly in the training group. In addition, ejection fraction and stroke volume increased significantly in the training group. Although left ventricular mass decreased in the training group, the difference between the two groups was not significant. Conclusion: An 8-week CRP in post-myocardial infarction patients can lead to improved systolic function and decreased left ventricular mass and thus prevent cardiomegaly

Novel approach for identification of influenza virus host range and zoonotic transmissible sequences by determination of host-related associative positions in viral genome segments

Background: Recent (2013 and 2009) zoonotic transmission of avian or porcine influenza to humans highlights an increase in host range by evading species barriers. Gene reassortment or antigenic shift between viruses from two or more hosts can generate a new life-threatening virus when the new shuffled virus is no longer recognized by antibodies existing within human populations. There is no large scale study to help understand the underlying mechanisms of host transmission. Furthermore, there is no clear understanding of how different segments of the influenza genome contribute in the final determination of host range. Methods: To obtain insight into the rules underpinning host range determination, various supervised machine learning algorithms were employed to mine reassortment changes in different viral segments in a range of hosts. Our multi-host dataset contained whole segments of 674 influenza strains organized into three host categories: avian, human, and swine. Some of the sequences were assigned to multiple hosts. In point of fact, the datasets are a form of multi-labeled dataset and we utilized a multi-label learning method to identify discriminative sequence sites. Then algorithms such as CBA, Ripper, and decision tree were applied to extract informative and descriptive association rules for each viral protein segment. Result: We found informative rules in all segments that are common within the same host class but varied between different hosts. For example, for infection of an avian host, HA14V and NS1230S were the most important discriminative and combinatorial positions. Conclusion: Host range identification is facilitated by high support combined rules in this study. Our major goal was to detect discriminative genomic positions that were able to identify multi host viruses, because such viruses are likely to cause pandemic or disastrous epidemics.Fatemeh Kargarfard, Ashkan Sami, Manijeh Mohammadi-Dehcheshmeh and Esmaeil Ebrahimi

Effects of stretching exercise training and ergonomic modifications on musculoskeletal discomforts of office workers: a randomized controlled trial

Objective: To evaluate the effectiveness of exercise, ergonomic modification, and a combination of training exercise and ergonomic modification on the scores of pain in office workers with neck, shoulders, and lower back pain. Methods: Participants (N = 142) in this randomized controlled trial were office workers aged 20–50 years old with neck, shoulders, and lower back pain. They were randomly assigned to either the ergonomic modification group, the exercise group, the combined exercise and ergonomic modification group, or the control group (no-treatment). The exercise training group performed a series of stretching exercises, while the ergonomic group received some modification in the working place. Outcome measures were assessed by the Cornell Musculoskeletal Disorders Questionnaire at baseline, after 2, 4, and 6 months of intervention. Results: There was significant differences in pain scores for neck (MD −10.55; 95%CI −14.36 to −6.74), right shoulder (MD −12.17; 95%CI −16.87 to −7.47), left shoulder (MD −11.1; 95%CI −15.1 to −7.09) and lower back (MD −7.8; 95%CI −11.08 to −4.53) between the exercise and control groups. Also, significant differences were seen in pain scores for neck (MD −9.99; 95%CI −13.63 to −6.36), right shoulder (MD −11.12; 95%CI −15.59 to −6.65), left shoulder (MD −10.67; 95%CI −14.49 to −6.85) and lower back (MD −6.87; 95%CI −10 to −3.74) between the combined exercise and ergonomic modification and control groups. The significant improvement from month 4 to 6, was only seen in exercise group (p < 0.05). Conclusion: To have a long term effective on MSDs, physical therapists and occupational therapists should use stretching exercises in their treatment programs rather than solely rely on ergonomic modification

Prevalence rate of neck, shoulder and lower back pain in association with age, body mass index and gender among Malaysian office workers

Background: Malaysian office workers often experience Musculoskeletal Discomfort (MSD) which is typically related to the low back, shoulders, and neck. Objectives: The objective of this study was to examine the occurrence of lower back, shoulder, and neck pain among Malaysian office workers. Methods: 752 subjects (478 women and 274 men) were randomly selected from the Malaysian office workers population of 10,000 individuals. The participants were aged between 20-50 years and had at least one year of work experience. All participants completed the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Instructions to complete the questinnaire were given to the participants under the researchers supervision in the morning before they started a day of work. The participants were then classified into four categories based on body mas index (BMI) (BMI:≤18.4, 18.5-24.99, 25-29.99, ≥30) and age (Age: 20-29, 30-39, 40-49, ≥50). Results: There was a significant association between pain severity in gender and right (p = 0.046) and left (p = 0.041) sides of the shoulders. There was also a significant association between BMI and severity of pain in the lower back area (p = 0.047). It was revealed that total pain score in the shoulders was significantly associated with age (p = 0.041). Conclusions: The results of this study demonstrated that a significant correlation existed between pain servity for gender in both right and left shoulder. These findings require further scientific investigation as do the identification of effective preventative stratgies

Borg CR-10 scale as a new approach to monitoring office exercise training

Background: There are many potential training exercises for office workers in an attempt to prevent musculoskeletal disorders. However, to date a suitable tool to monitor the perceived exertion of those exercises does not exist. Objective: The primary objective of this study was to examine the validity and reliability of the Borg CR-10 scale to monitor the perceived exertion of office exercise training. Methods: The study involved 105 staff members employed in a government office with an age range from 25 to 50 years. The Borg CR-10 scale was self-administered two times, with an interval of two weeks in order to evaluate the accuracy of the original findings with a retest. Face validity and content validity were also examined. Results: Reliability was found to be high for the Borg CR-10 scale (0.898). Additionally a high correlation between the Borg CR-10 scale and Visual Analog Scale (VAS) was identified (rs = 0.754, P < 0.01). Conclusions: This study found the Borg CR-10 scale to be a reliable and valid tool for monitoring the perceived exertion of office exercise training and may potentially be useful for occupational therapists to measure physical activity intensity levels

Identifying mutation positions in all segments of influenza genome enables better differentiation between pandemic and seasonal strains

Influenza has a negative sense, single-stranded, and segmented RNA. In the context of pandemic influenza research, most studies have focused on variations in the surface proteins (Hemagglutinin and Neuraminidase). However, new findings suggest that all internal and external proteins of influenza viruses can contribute in pandemic emergence, pathogenicity and increasing host range. The occurrence of the 2009 influenza pandemic and the availability of many external and internal segments of pandemic and non-pandemic sequences offer a unique opportunity to evaluate the performance of machine learning models in discrimination of pandemic from seasonal sequences using mutation positions in all segments. In this study, we hypothesized that identifying mutation positions in all segments (proteins) encoded by the influenza genome would enable pandemic and seasonal strains to be more reliably distinguished. In a large scale study, we applied a range of data mining techniques to all segments of influenza for rule discovery and discrimination of pandemic from seasonal strains. CBA (classification based on association rule mining), Ripper and Decision tree algorithms were utilized to extract association rules among mutations. CBA outperformed the other models. Our approach could discriminate pandemic sequences from seasonal ones with more than 95% accuracy for PA and NP, 99.33% accuracy for NA and 100% accuracy, precision, specificity and sensitivity (recall) for M1, M2, PB1, NS1, and NS2. The values of precision, specificity, and sensitivity were more than 90% for other segments except PB2. If sequences of all segments of one strain were available, the accuracy of discrimination of pandemic strains was 100%. General rules extracted by rule base classification approaches, such as M1-V147I, NP-N334H, NS1-V112I, and PB1-L364I, were able to detect pandemic sequences with high accuracy. We observed that mutations on internal proteins of influenza can contribute in distinguishing the pandemic viruses, similar to the external ones