Neuromusculoskeletal disorders in patients with Type 2 diabetes mellitus: Outcome of a twelve-week Therapeutic exercise programme

Usual line of management of diabetes patients is drug and diet with theirphysical needs usually receiving minimal attention. Among the physical needs, requiring attention is their neuromusculoskeletal disorders. This study was designed to investigate the effect of a twelve-week therapeuticexercise on neuromusculoskeletal disorders ofType 2 Diabetes (T2D) patients. Forty-three participants from the Diabetes Specialty Clinic ofAminu KanoTeaching Hospital, Kano completed the study. Selected neuromusculoskeletal disorders including pain, dermatological foot grades,disorders of ranges of motion and strength of selected joints and muscles were assessed before and after a period of twelve weeks of therapeutic exercises. Participants were followed up for another twelve weekswithout therapeutic exercises. Baseline assessment revealed poor neuromusculoskeletal status. Significant improvements (P0.05). T2D patients presented with neuromusculoskeletal disorders at baseline. Therapeutic exercises however assisted in the improvement of these disorders but relapsed when exercises were suspended. Engagement in therapeutic exercises enhanced neuromusculoskeletal health, while withdrawal from the exercise contributed to a decline. T2D patients should be encouraged to participate in therapeutic exercises in order to promote their health and function

Relationship of Waist-Hip Ratio and Body Mass Index to Blood Pressure of Individuals in Ibadan North Local Government

Several studies have shown that there is a significant relationship between relative weight and hypertension. The anatomical distribution of weight has also been shown to be a factor in determining which people are more susceptible to hypertension and thus at risk of developing cardiovascular diseases. This study investigated the relationship between two anthropometric measurements for obesity – body mass index (BMI) and waist-hip ratio (WHR), and the blood pressure of Nigerians aged 15-85 years. The study employed a cross-sectional survey of individuals living in Ibadan North Local Government Area of Oyo State. Four hundred and four male and female individuals were recruited using a non-probability sampling technique. Measurements taken include subjects’ systolic and diastolic blood pressure, waist and hip girths, height, and weight. Information was obtained about lifestyle and occupation as well as familial history of hypertension, diabetes, cardiac and renal diseases. Data was analysed using descriptive and inferential statistics, with alpha set at 0.05. Results show that WHR and BMI had a linear relationship with the blood pressure of the participants. KEY WORDS: blood pressure, body mass index, waist-hip ratio, hypertensio

Increase in Adiposity of Type 2 Diabetes Patients following Withdrawal from Therapeutic Exercise

In order to achieve optimum health status, Type 2 Diabetes (T2D) patients are usually encouraged to undergo regular and consistent therapeutic exercises. This study investigated whether the gains of exercises on adiposity variables of T2D patients are maintained within a few weeks of withdrawal from exercise and whether it was significantly related to the age of the patient and the duration of diagnosis of T2D. Forty-three T2D patients aged between 30 and 64 years were recruited for this study. They were placed on a combination of endurance and strengthening exercises for 12 weeks. The participants were thereafter observed for another 12 weeks without exercises. The adiposity variables measured in both phases of the study include: body mass index (BMI), waist circumference (WC), waist-hip-ratio (WHR) and percent-body-fat (PBF). Significant improvements (P less than 0.05) for all the variables were achieved after 12 weeks of therapeutic exercises. The variables, however, showed significant relapses (P less than 0.05) within six weeks of withdrawal of exercise and these were significantly related (P less than 0.05) to both the age of the patient and the duration of diagnosis. The endurance and strengthening exercises improved the adiposity variables of theT2D patients, but the gains began to decline within six weeks of withdrawal from the exercises. The increase in adiposity was more as the age and duration of diagnosis of the patients increased. KEY WORDS: weight maintenance, body composition, diabetes mellitu

Physical Activity and Pattern of Blood Pressure in Postmenopausal Women With Hypertension in Nigeria

Background: Hormonal changes during menopause have been attributed to hypertension-a common public health concern. This study investigated physical activity (PA) and pattern of blood pressure (BP) in postmenopausal women newly diagnosed with hypertension and referred for treatment at the medicine outpatient clinic of a tertiary health facility in Ibadan, Oyo State, Nigeria. It compared BP pattern and adiposity variables [body mass index (BMI) and waist-hip ratio (WHR)] between two PA groups.Methods: Purposive sampling technique was used to recruit 220 participants in this cross-sectional survey after obtaining their informed consent. International Physical Activity Questionnaire was used to assess PA level, while a 16-item questionnaire was used to assess socio-demographic and clinical profiles of the women. BP, BMI and WHR were assessed using standard measurement procedures. Descriptive statistics of mean ± standard deviation were used for data summarization and independent t-test was used to compare variables between low level and moderate to vigorous level PA groups.Results: Participants’ mean values include: age 61.6 ± 8.5 years, years since menopause 12.75± 8.15, BMI 28.63±4.99kg/m2, WHR 1.11±0.08, SBP and DBP 145.9±17.9; 93.7±11.4 mmHg respectively. Mean values of SBP, DBP, BMI and WHR were higher among participants with low PA compared to those with moderate to vigorous even though the difference was not statistically significant (P>0.05).Conclusion: Involvement in moderate to vigorous physical activities among menopausal women in Nigeria should be encouraged. This may reduce hypertension and adiposity with a possible control of cardiovascular disease risk.Keywords: Postmenopausal, Hypertension, Physical Activity, Blood Pressure, Adiposit

Intra-articular temperatures of the knee in sports – An in-vivo study of jogging and alpine skiing

<p>Abstract</p> <p>Background</p> <p>Up to date, no information exists about the intra-articular temperature changes of the knee related to activity and ambient temperature.</p> <p>Methods</p> <p>In 6 healthy males, a probe for intra-articular measurement was inserted into the notch of the right knee. Each subject was jogging on a treadmill in a closed room at 19°C room temperature and skiing in a ski resort at -3°C outside temperature for 60 minutes. In both conditions, temperatures were measured every fifteen minutes intra-articulary and at the skin surface of the knee. A possible influence on joint function and laxity was evaluated before and after activity. Statistical analysis of intra-articular and skin temperatures was done using nonparametric Wilcoxon's sign rank sum test and Mann-Whitney's-U-Test.</p> <p>Results</p> <p>Median intra-articular temperatures increased from 31.4°C before activity by 2.1°C, 4°C, 5.8°C and 6.1°C after 15, 30, 45 and 60 min of jogging (all p ≤ 0.05). Median intra-articular temperatures dropped from 32.2°C before activity by 0.5°C, 1.9°C, 3.6°C and 1.1°C after 15, 30, 45 and 60 min of skiing (all n.s.). After 60 minutes of skiing (jogging), the median intra-articular temperature was 19.6% (8.7%) higher than the skin surface temperature at the knee. Joint function and laxity appeared not to be different before and after activity within both groups.</p> <p>Conclusion</p> <p>This study demonstrates different changes of intra-articular and skin temperatures during sports in jogging and alpine skiing and suggests that changes are related to activity and ambient temperature.</p

Mechanosensitivity during lower extremity neurodynamic testing is diminished in individuals with Type 2 Diabetes Mellitus and peripheral neuropathy: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Type 2 Diabetes Mellitus (T2DM) and diabetic symmetrical polyneuropathy (DSP) impact multiple modalities of sensation including light touch, temperature, position sense and vibration perception. No study to date has examined the mechanosensitivity of peripheral nerves during limb movement in this population. The objective was to determine the unique effects T2DM and DSP have on nerve mechanosensitivity in the lower extremity.</p> <p>Methods</p> <p>This cross-sectional study included 43 people with T2DM. Straight leg raise neurodynamic tests were performed with ankle plantar flexion (PF/SLR) and dorsiflexion (DF/SLR). Hip flexion range of motion (ROM), lower extremity muscle activity and symptom profile, intensity and location were measured at rest, first onset of symptoms (P1) and maximally tolerated symptoms (P2).</p> <p>Results</p> <p>The addition of ankle dorsiflexion during SLR testing reduced the hip flexion ROM by 4.3° ± 6.5° at P1 and by 5.4° ± 4.9° at P2. Individuals in the T2DM group with signs of severe DSP (n = 9) had no difference in hip flexion ROM between PF/SLR and DF/SLR at P1 (1.4° ± 4.2°; paired t-test p = 0.34) or P2 (0.9° ± 2.5°; paired t-test p = 0.31). Movement induced muscle activity was absent during SLR with the exception of the tibialis anterior during DF/SLR testing. Increases in symptom intensity during SLR testing were similar for both PF/SLR and DF/SLR. The addition of ankle dorsiflexion induced more frequent posterior leg symptoms when taken to P2.</p> <p>Conclusions</p> <p>Consistent with previous recommendations in the literature, P1 is an appropriate test end point for SLR neurodynamic testing in people with T2DM. However, our findings suggest that people with T2DM and severe DSP have limited responses to SLR neurodynamic testing, and thus may be at risk for harm from nerve overstretch and the information gathered will be of limited clinical value.</p

Cardio–Pulmonary Response Of Patients With Sickle Cell Anaemia DiseaseTo Exercise Test

The purpose of this study was to compare the response of sickle cell anaemia patients with their age-matched counterparts to exercise test. This was to see whether patients with sickle cell disease could be given exercise therapy without any risk of adverse cardio-respiratory response during the course of physical rehabilitation. A total of 70 subjects participated in the study; 30 of these had Haemoglobin type SS (HBSS-or sickling group) and were aged 18.57+3.06 years. Forty had Haemoglobin AA (HBAA or control group) and were aged 19.33 + 3.02 years. The cardio-pulmonary parameters (systolic blood pressure, diastolic blood pressure, pulse rate and respiratory rate) were measured at rest, during exercise and after exercise. The subjects went through step tests at stepping rates of 18 steps per minute and 24 steps per minute. Mean pulse rate at rest for the control group (HbAA) and HbSS groups were 77.40 + 8.90/min and 95.03 + 9.25/min respectively, while pulse rate at 24 steps/min for the control and HbSS groups were 131.83+9.36/min and 158.60+7.61/min respectively. It was concluded that the response of the sickle-cell anaemia patients to exercise features a relatively high cardiac output manifesting as a higher than expected heart rate for a sub-maximal workload. This shows that the sickle-cell anaemia patients could be easily fatigued and should not be subjected to high physical exertion as their healthy peers. Exercise therapy programme in the course of Physiotherapy for sickle cell anaemia patients must be carefully prescribed, closely monitored and cautiously progressed. Nigerian Quarterly Journal of Hospital Medicine Vol.9, No.3 (1999) pp. 172-17

Cardiovascular Response Of Diabetic And Non-Diabetic Nigerian Subjects To a Single Bout Of Bicycle Ergometry

This study assessed the cardiovascular responses of diabetic and non-diabetic subjects to a single bout of bicycle ergometry. Ten male volunteer diabetics and ten male non-diabetic healthy subjects constituted the study and control groups respectively. The subjects exercised for ten minutes on a bicycle ergometer. Heart rate, systolic and diastolic blood pressures were measured pre-and post-exercise. Descriptive statistics of mean, standard deviation, and inferential statistics of t-test were calculated. The results of this study showed no significant difference in the age, weight and pre-exercise heart rate of the 2 groups (p > 0.05). Resting systolic and diastolic blood pressures were significantly higher for the diabetics than non-diabetic subjects (