Influence of a home-based exercise intervention on human health indices in individuals with chronic spinal cord injury (HOMEX-SCI):study protocol for a randomized controlled trial

BACKGROUND: Spinal cord injury (SCI) creates a complex pathology that can lead to an increase in sedentary behaviours and deleterious changes in body composition. Consequently, individuals with SCI are at increased risk of developing cardiovascular disease and type-2 diabetes mellitus. While the role of physical activity on the reduction of chronic disease risk is well documented in non-disabled individuals the evidence is less conclusive for persons with SCI. The aim of this methodological paper is to outline the design of a study that will assess the role of a home-based exercise intervention on biomarkers of metabolic and cardiovascular health in persons with SCI: the HOMEX-SCI study. METHODS/DESIGN: Eligible participants will be inactive (physical activity level ≤1.60) individuals, with a chronic (more than 1 year) spinal cord lesion between the second thoracic and the fifth lumbar vertebrae, and aged between 18 and 65 years. Following baseline laboratory testing and lifestyle monitoring, participants will be randomly allocated to a control (CON) group or a 6-week home-based exercise intervention (INT) group. The INT consists of 45 minutes of moderate-intensity (60–65 % peak oxygen uptake) arm-crank exercise four times per week. Participants assigned to the CON group will be asked to maintain their normal lifestyle. The main outcomes of this study (biomarkers of metabolic and cardiovascular health) are obtained from venous blood samples, collected in the fasted and postprandial state. Eight other measurement categories will be assessed: (1) body composition, (2) physical activity, (3) energy intake, (4) measures of health and wellbeing, (5) resting metabolic rate, heart rate and blood pressure, (6) aerobic capacity, (7) immune function, and (8) adipose tissue gene expression. DISCUSSION: This study will explore the feasibility of home-based moderate-intensity exercise and ascertain its impact on metabolic and cardiovascular health in comparison to a lifestyle maintenance CON group. Findings from this study may help to inform new evidence-based physical activity guidelines and also help to elucidate the physiological mechanisms whereby exercise might exert beneficial effects in persons with chronic SCI. The results will also act as a scientific platform for further intervention studies in other diverse and at-risk populations. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number: ISRCTN57096451. Registered on 11 July 2014

The Vehicle, April 1959, Vol. 1 no. 1

Vol. 1, No. 1 Table of Contents Aunt OraHelen Leepage 3 Ethnocentrismpage 7 FashionsLinda Lyonspage 7 On Giving Up Auden in DespairHelen Leepage 8 The Vagaries of ComplianceHelen Leepage 8 The StormJean Nightingalepage 9 Sonnet to SubjectWayne Nelmspage 9 The Killing of Mr. KitAl Brookspage 10 ShortsC.E.S.page 16https://thekeep.eiu.edu/vehicle/1000/thumbnail.jp

Logarithmic corrections to correlation decay in two-dimensional random-bond Ising systems

The statistics of critical spin-spin correlation functions in Ising systems with non-frustrated disorder are investigated on a strip geometry, via numerical transfer-matrix techniques. Conformal invariance concepts are used, in order to test for logarithmic corrections to pure power-law decay against distance. Fits of our data to conformal-invariance expressions, specific to logarithmic corrections to correlations on strips, give results with the correct sign, for the moments of order $n=0-4$ of the correlation-function distribution. We find an interval of disorder strength along which corrections to pure-system behavior can be decomposed into the product of a known $n$-dependent factor and an approximately $n$-independent one, in accordance with predictions. A phenomenological fitting procedure is proposed, which takes partial account of subdominant terms of correlation-function decay on strips. In the low-disorder limit, it gives results in fairly good agreement with theoretical predictions, provided that an additional assumption is made.Comment: Final version, accepted for publication in Physical Review

Biomarkers of cardiometabolic health are associated with body composition characteristics but not physical activity in persons with spinal cord injury

Objective: To examine (i) the associations between physical activity dimensions, cardiorespiratory fitness and body composition and, (ii) the associations between physical activity dimensions, cardiorespiratory fitness, body composition and biomarkers of cardiometabolic health in persons with spinal cord injury (SCI). Methods: A cross-sectional prospective cohort study with 7-day follow-up was conducted. Body composition, cardiorespiratory fitness and biomarkers of cardiometabolic health were measured in thirty-three participants with SCI (&gt; 1 year post injury). Physical activity dimensions were objectively assessed over 7-days. Results: Activity energy expenditure (r =.43), physical activity level (r =.39), and moderate-to-vigorous physical activity (MVPA) (r =.48) were significantly (P &lt; 0.001) associated with absolute (L/min) peak oxygen uptake (⩒O 2 peak). ⩒O 2 peak was significantly higher in persons performing ≥150 MVPA minutes/week compared to &lt;40 minutes/week (P = 0.003). Individual physical activity dimensions were not significantly associated with biomarkers of cardiometabolic health. However, body composition characteristics (BMI, waist and hip circumference) showed significant (P &lt; 0.04), moderate (r &gt;.30) associations with parameters of metabolic regulation, lipid profiles and inflammatory biomarkers. Relative ⩒O 2 peak (ml/kg/min) was moderately associated with only insulin sensitivity (r = 0.37, P = 0.03). Conclusions: Physical activity dimensions are associated with cardiorespiratory fitness; however, stronger and more consistent associations suggest that poor cardiometabolic health is associated with higher body fat content. Given these findings, the regulation of energy balance should be an important consideration for researchers and clinicians looking to improve cardiometabolic health in persons with SCI. </p

The Vehicle, June 1959, Vol. 1 no. 3

Vol. 1, No. 3 Table of Contents FrustrationNeil Parkerpage 3 Public FigureBert Browderpage 8 To a Young LadyNeil Parkerpage 8 Eastern -- YesterdayLinda Lyonspage 9 Glosing Won\u27t ServeD.E. Fullerpage 10 D. Linkwant at the BarD. Linkwantpage 10 The Wedgewood CupBarbara Wilson Dautpage 11 The SymptomsBert Browderpage 14 On a Charge for Over-DrawingD.E. Fullerpage 14 Information, PleaseD.E. Fullerpage 14 Query from Row Two, Seat ThreeHunkelheimerpage 15 DeceptionBarbara Wilson Dautpage 15 Binge in Mind?Anon.page 15 A CommaJean Nightingalepage 16 Miss Me, Kate!A.B. Carterpage 16 My SinsJean Nightingalepage 16https://thekeep.eiu.edu/vehicle/1002/thumbnail.jp

The Vehicle, June 1959, Vol. 1 no. 3

Vol. 1, No. 3 Table of Contents FrustrationNeil Parkerpage 3 Public FigureBert Browderpage 8 To a Young LadyNeil Parkerpage 8 Eastern -- YesterdayLinda Lyonspage 9 Glosing Won\u27t ServeD.E. Fullerpage 10 D. Linkwant at the BarD. Linkwantpage 10 The Wedgewood CupBarbara Wilson Dautpage 11 The SymptomsBert Browderpage 14 On a Charge for Over-DrawingD.E. Fullerpage 14 Information, PleaseD.E. Fullerpage 14 Query from Row Two, Seat ThreeHunkelheimerpage 15 DeceptionBarbara Wilson Dautpage 15 Binge in Mind?Anon.page 15 A CommaJean Nightingalepage 16 Miss Me, Kate!A.B. Carterpage 16 My SinsJean Nightingalepage 16https://thekeep.eiu.edu/vehicle/1002/thumbnail.jp

Home-based exercise enhances health-related quality of life in persons with spinal cord injury::a randomized controlled trial

Objective: To assess the influence of a home-based exercise intervention on indices of health-related quality of life (HRQOL) in persons with spinal cord injury (SCI). Design: This was a randomized controlled trial (HOMEX-SCI; ISRCTN57096451). After baseline laboratory testing and a week of free-living physical activity monitoring, eligible participants were randomly assigned (2:1 allocation ratio) to a home-based moderate-intensity upper-body exercise intervention group (INT, n=13), or a lifestyle maintenance control group (CON, n=8), for 6 weeks. Setting: Home-based with short laboratory visits immediately before and after the intervention/control period. Participants: Inactive participants (N=21) with chronic (&gt;1yr) SCI (injury level &lt;T4). Intervention: Participants assigned to the INT completed 4, 45-minute moderate-intensity (60%-65% peak oxygen uptake) arm-crank exercise sessions per week for 6 weeks. Participants assigned to the control group (CON) were asked to maintain their habitual physical activity behavior. Main Outcome Measures: Secondary outcome measures were assessed, including physical and mental component scores (PCS and MCS) of health-related quality of life (HRQOL), fatigue, global fatigue (FSS), and shoulder pain index (WUSPI). Cardiorespiratory fitness (CRF), objectively measured habitual moderate-to-vigorous physical activity (MVPA), and exercise self-efficacy (ESE) were also assessed at baseline and follow-up. Results: Changes in the PCS (P=.017) of the Short Form 36 Health Survey (SF-36), ESE (P=.011), and FSS (P=.036) were significantly different between the 2 groups, with moderate to large effect sizes (d=0.75-1.37). Various HRQOL outcomes demonstrated likely to very likely positive inferences in favor of the INT group following the 6-week exercise intervention. Changes in ESE were significantly (P&lt;.01) associated with changes in PCS (r=0.62), MCS (r=0.71), FSS (r=-0.71), and global fatigue (r=0.57). Conclusions: A 6-week upper-body exercise intervention improved indices of HRQOL in persons with SCI. Improvements were associated with increases in ESE. While this intervention demonstrated a positive effect on perceived physical functioning, future interventions should aim to support social and mental functioning and exercise maintenance.</p

Influence of accelerometer type and placement on physical activity energy expenditure prediction in manual wheelchair users

To assess the validity of two accelerometer devices, at two different anatomical locations, for the prediction of physical activity energy expenditure (PAEE) in manual wheelchair users (MWUs).Seventeen MWUs (36 ± 10 yrs, 72 ± 11 kg) completed ten activities; resting, folding clothes, propulsion on a 1% gradient (3,4,5,6 and 7 km·hr-1) and propulsion at 4km·hr-1 (with an additional 8% body mass, 2% and 3% gradient) on a motorised wheelchair treadmill. GT3X+ and GENEActiv accelerometers were worn on the right wrist (W) and upper arm (UA). Linear regression analysis was conducted between outputs from each accelerometer and criterion PAEE, measured using indirect calorimetry. Subsequent error statistics were calculated for the derived regression equations for all four device/location combinations, using a leave-one-out cross-validation analysis.Accelerometer outputs at each anatomical location were significantly (p < .01) associated with PAEE (GT3X+-UA; r = 0.68 and GT3X+-W; r = 0.82. GENEActiv-UA; r = 0.87 and GENEActiv-W; r = 0.88). Mean ± SD PAEE estimation errors for all activities combined were 15 ± 45%, 14 ± 50%, 3 ± 25% and 4 ± 26% for GT3X+-UA, GT3X+-W, GENEActiv-UA and GENEActiv-W, respectively. Absolute PAEE estimation errors for devices varied, 19 to 66% for GT3X+-UA, 17 to 122% for GT3X+-W, 15 to 26% for GENEActiv-UA and from 17.0 to 32% for the GENEActiv-W.The results indicate that the GENEActiv device worn on either the upper arm or wrist provides the most valid prediction of PAEE in MWUs. Variation in error statistics between the two devices is a result of inherent differences in internal components, on-board filtering processes and outputs of each device