Exergaming and Aquatic Exercises Affect Lung Function and Weight Loss in Obese Children.

Objective: The purpose of this study was to investigate the effects of an additional weight aquatic exercise program on the balance and lower extremity strength on aquatic environment in persons with stroke. Design: Randomized controlled trial. Methods: All subjects were randomly divided into three groups where thirteen subjects were in the additional weight aquatic exercise group, twelve subjects in the aquatic exercise group, and fifteen subjects in the control group. Subjects received a graded aquatic exercise program for 30 minutes, with 3 sessions per week for 6 weeks, and subjects in all groups received conventional physical therapy. All subjects were assessed with the Medical Research Council (MRC), the Berg Balance scale (BBS), Timed Up and Go test (TUG), and 10-meter walk test (10MWT) pre and post intervention. Results: The MRC, BBS, TUG, and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved in all areas post-treatment (p<0.05). In addition, it has been confirmed that the additional weight aquatic exercise group had significantly improved in MRC, BBS, and TUG scores compared with the aquatic exercise and control group (p<0.05). Conclusions: The findings of this study suggested that the additional weight aquatic exercise program improves lower extremity and balance in persons with stroke.

Addressing overweight and obesity to promote healthy aging is essential. Exercise is an outstanding approach to manage metabolic and physical dysfunction. Aquatic exercise has been recommended for older individuals due to reduced weight pressure on joints. The aim of this study was to determine the effects of twenty-eight weeks of combined aquatic exercise (aerobic and resistance) in overweight healthy older individuals. Thirty-two subjects of both genders with mean age of 72.06 ± 5.8 years were randomly assigned into two groups: an aquatic exercise group (EG; n = 19) and a control group (CG; n = 13). Body composition, anthropometric measurements, blood pressure, lipid profile, fasting glucose, insulin, and leptin were assessed before and after the training program. The lipid profile, fasting glucose, leptin, insulin, and insulin resistance did not change between and within groups. The lipid profile worsened in the CG. Reduction in body fat mass, waist and leg circumferences, along with body mass gain in the aquatic exercise group was observed (p ≤ 0.05). Systolic and diastolic blood pressure significantly improved in the exercise group (P = 0.003, P = 0.001). Significant differences were found in aerobic endurance (P = 0.008) and lower body flexibility (P = 0.049) of the aquatic exercise group compared with the control group. Also, upper body flexibility (P = 0.001, P = 0.020), lower and upper body strength (P = 0.001, P = 0.031), and handgrip (P = 0.001, P = 0.006), showed significant differences within the exercise group. Aquatic exercise may have a positive impact on the overweight aging population’s metabolic and cardiovascular parameters, based on the observed improvements in blood pressure and body composition.

Multiple sclerosis (MS) is a chronic disease affecting all aspects of life in patients with this disease and causes a wide range of functional problems, including reduced walking capacity. The aim of this study was to compare the effects of 8 weeks aquatic, land-based and combined (aquatic-land (exercise programs according to Burdenko method on the walking capacity measured by 6-Minute Walk Test (6MWT). This was a pre- post design study. Thirty one women diagnosed with MS, age range 30-50 years, EDSS&lt;4.5, and living in Amol, Iran participated in this study. The paired t-test results demonstrated a significant improvement in the walking ability of individuals after aquatic exercises (t = -2.23, α=0.048), land-based exercises (t = -5.31, α= 0.001) and combined exercises (t = -4.00, α = 0.001) compared to the pretest. The results of covariance test indicated that aquatic, land-based and combined exercise programs had different effects on the walking ability (power = 0.80, P = 0.001, and F30, 2 = 8.98). Results of LSD post hoc analysis further indicated that the mean 6MWT in the land-based exercise group and combined exercise group was significantly higher than the aquatic exercise group (p&lt;0.05), but no significant difference was found in the mean of 6MWT between land-based exercise group and combined exercise group (p&gt;0.05). According to the results of this study, the combined and land-based exercises can be suggested for people with MS in order to improve their walking capacity. These methods can be suggested as appropriate non-pharmacologic complementary therapies in the rehabilitation centers.

Adipokines in adolescence; the associations with lung function and atopy – A cross-sectional study

[Purpose] The purpose of this study was to investigate the effect of an aquatic environment on the balance of stroke patients compared to a land environment. [Subjects and Methods] Forty-six subjects participated in this study. They were divided into a land exercise (LE) group (13 males, 10 females) and an aquatic exercise (AE) group (12 males, 11 females). Exercises were conducted six times a week for six weeks. Balance was assessed through parameters of sway of the center of pressure. [Results] The exercises improved the balance abilities of both groups with eyes open. With eyes closed, balance ability improved more in the AE group, and AE was more important than vision for improving the balance ability of stroke patients. [Conclusion] This study found that stroke patients had better balance in an aquatic environment than in a land environment.

BackgroundThe mat Pilates method is the therapeutic modalities which can be used in fibromyalgia treatment. Although there are no well-designed studies that prove the effectiveness of the mat Pilates method in this population. The objective was to evaluate the effectiveness of the mat Pilates method for improving symptoms in women with fibromyalgia.MethodsA single blind randomized controlled trial in which 42 women with fibromyalgia were randomized into two groups: mat Pilates and aquatic aerobic exercise. The exercises were performed twice a week for 12 weeks. Two evaluations were performed: one at baseline (T0), and another at 12 weeks after randomization (T12). The primary outcome was pain measured by the Visual Analogue Scale (VAS). Secondary outcomes were function (Fibromyalgia Impact Questionnaire), sleep (Pittsburgh Sleep Quality Index [PSQI]), quality of life (Short Form 36 [SF-36]), fear avoidance (Fear Avoidance Beliefs Questionnaire [FABQ-BR]) and pain catastrophizing (Pain-Related Catastrophizing Thoughts Scale [PRCTS]).ResultsThere was improvement in both groups in relation to pain and function (p < 0.05). The aspects related to quality of life and the FABQ questionnaire only showed improvement in the mat Pilates group (p < 0.05). There was improvement in the PSQI and PRCTS variables only in the aquatic aerobic exercise group (p < 0.05), but no differences were observed between the groups for any of the evaluated variables.ConclusionSignificant improvements were observed in the two groups in relation to the disease symptoms, and no differences were observed between mat Pilates and aquatic aerobic exercise in any of the measured variables.Trial registrationClinicalTrials.gov Identifier (NCT03149198), May 11, 2017. Approved by the Ethics Committee of FACISA/UFRN (Number: 2.116.314).

Postural sway characteristics in women with lower extremity arthritis before and after an aquatic exercise intervention

Correction to: Exergaming and Aquatic Exercises Affect Lung Function and Weight Loss in Obese ChildrenInt J Sports Med 2021; 42(06): 566-572DOI: 10.1055/a-1289-9307

The parameters used to assess aerobic exercise function by gas exchange are usually adjusted for body mass and are expressed as millilitres per minute per kilogram. In the case of obese children this could lead to overcorrection with an underestimation of their exercise capacity. The purpose of the present study was to assess cardiorespiratory exercise function in obese subjects using body mass-independent parameters. As both carbon dioxide output (VCO2) and oxygen uptake (VO2) are usually corrected for body mass, the slope of VCO2 versus VO2 can be considered to be independent of body mass. This slope was calculated below the ventilatory threshold (S1) and above the ventilatory threshold (S3). Exercise tests were performed on a treadmill and respiratory gas exchange was measured breath-by-breath. A group of 29 obese children [mean age 11 (SD 2.5) years] were compared to 16 normal controls of the same age range [mean age 10.8 (SD 2.2); P > 0.05]. The patients were overweight by 36 (SD 17.9)% and had a body mass index of 25.0 (SD 3.8). The results showed that S3 in the obese subjects was significantly steeper compared to the normal controls [1.30 (SD 0.20) vs 1.10 (SD 0.20); P < 0.05]. The steepest values for S3 were found in the subjects with the highest degree of obesity. This method has some limitations, since in a large proportion of the patients (48%) no ventilatory threshold could be detected, which is prerequisite for calculation of these slopes. The latter was already suppressed at the onset of exercise in 21% of the sample or could not be detected because of breathing irregularity in 27%. It is suggested from this study that cardiorespiratory exercise function in obese children is reduced, especially when assessed by parameters of aerobic exercise which cancel the confounding effect of body mass.

To evaluate β-cell function in obese children and adolescents meeting clinical criteria for isolated obesity (iOB), isolated components of dysmetabolism (cMD), or metabolic syndrome (MS), and in obese children and adolescents with normal glucose tolerance (NGT), impaired glucose regulation (IGR), or type 2 diabetes (T2DM). We undertook a prospective study of Han Chinese children and adolescents aged 8-16 years (median 11 ± 1.4) seen in an obesity clinic between May 2013 and 2018. Patients were classified as iOB (53), cMD (139), and MS (139) groups based on clinical criteria. The same patients were also classified as NGT (212), IGR (111), or T2DM (8) based on results of an oral glucose tolerance test (OGTT). The MS patients were classified as NGT [MS](59) and IGR [MS](72) for the further study. All participants also completed a mixed-meal tolerance test (MMTT). Compared with the iOB group, the MS group had significantly higher area under the curve of C-peptide up to the 2 hours (AUC CP) (P = .03) and peak C-peptide (P = .03), adjusted for BMI, age and Tanner stage, on MMTT. However, there was no difference in the insulinogenic index (ΔI30/ΔG30) or oral disposition index (oDI) derived from the OGTT among the three groups. However, 52% of participants with MS had IGR, compared to 28% in the cMD group. Compared with the NGT group, the individuals with IGR had significantly lower ΔI30/ΔG30 (P = .001) and oDI (P < .001). Compared with the iOB group, the NGT[MS] had significantly higher AUC CP (P = .004), peak C-peptide (P = .004) and ΔI30/ΔG30 (P = .007) adjusted for age, but no difference in oDI. Compared with the NGT[MS], the IGR[MS] had significantly lower ΔI30/ΔG30 (P = .005) and oDI (P < .001), but the AUC CP and peak C-peptide had no difference. Although the MS youth have β-cell hyperfunction as a whole, β-cell dysfunction is present in the early stages of dysmetabolism in obese youth with cMD or MS and worsened across the spectrum from iOB to cMD and MS, contributing to development of T2DM.

BackgroundCurrent adult studies suggest that uric acid (UA) is associated with body fat, but the relationship in obese children is unclear. Thus, we aim to evaluate the association between uric acid and body composition of obese children.MethodsA total of 79 obese children were included in this study, and 52 children (34 boys and 18 girls) underwent a 6-week weight loss camp, including 34 boys and 18 girls. Six-week weight-loss interventions were performed on all participants through aerobic exercise and appropriate dietary control. Laboratory tests and body composition were collected before and after the intervention.ResultsBefore the intervention, correlation analysis demonstrated that uric acid was positively correlated with height, weight, body mass index (BMI), waist circumference, hip circumference, fat mass (FM), and free fat mass (FFM) with adjusting for age and gender (P < 0.05). After 6 weeks of intervention, the participants gained 3.12 ± 0.85 cm in height, body fat percentage decreased by 7.23 ± 1.97%, and lost 10.30 ± 2.83 kg in weight. Univariate and multivariate analysis indicated that uric acid at baseline was associated with FM reduction during weight loss (P < 0.05).ConclusionsThis study is the first report that uric acid is associated with BMI and FM, and may play an important role in the reduction of FM during weight loss in obese children and adolescents. The interaction between UA and adiposity factors and its underlying mechanisms need to be further explored.Trial registrationThis study was registered in Clinical Trials.gov (NCT03490448) and approved by the Ethics Committee of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine.

Effect of diet and controlled exercise on weight loss in obese children

Clinical experiences indicate that aquatic exercises may have advantages for osteoarthritis patients. The purpose of this study was to examine the effects of aquatic exercise training on the knee pain and its symptoms as well as on the motor performance associated with daily living activities (ADL), sport-recreational activities, and the quality of life in men over 50. 30 men over 50 years old who suffered from knee osteoarthritis were selected voluntarily and were randomly assigned to aquatic exercise therapy and control groups. The means and standard deviations of age, height and weight of participants in each group were 54.26 ± 3.08 and 57.6 ± 5.76 yr; 169 ± 4.99 and 168.13 ± 4.76 cm; and 76.33 ± 8.11 and 71.53 ± 8.09 kg, respectively. Aquatic exercise training was carried out 3 times per week for 6 weeks. Knee pain, symptoms, motor function in daily activities and sportrecreation and quality of life were measured before and after exercise training. Results showed that the knee pain, symptoms, motor function in daily and sports – recreational activities and quality of life after the exercise protocol significantly improved in the aquatic exercise group (P 0.05). The results showed that aquatic exercises, as a safe and effective exercise method, could be incorporated to improve the pain, motor functions and quality of life in over-50-year-old males with knee osteoarthritis.

Bone Mineral Content, Lean and Fat Body Mass after Significant Weight Loss in Obese Children and Adolescents

The role of diet glycemic index (GI) in the control of orexigenic and anorexigenic factors of the energy balance is still not clear. The present study aimed to assess whether the habitual diet, according to different GI foods, exerts influence on regulation of energy balance markers and the effects of interdisciplinary intervention in obese adolescents. A total of 55 obese adolescents, aged from 14 to 19 years, were submited to one year of interdisciplinary therapy and were divided in two groups, according to the predominant dietary pattern of food intake: high-GI group (H-GI; n = 29) and moderate/low-GI group (M/L-GI; n = 26). The concentration of orexigenic factor AgRP (p < 0.01), visceral fat (p=0.04) and visceral/subcutaneous ratio (p = 0.03) were higher in the group of H-GI when compared with M/L-GI group. Moreover, the habitual consumption of H-GI foods was an independent predictor to explain changes in AgRP concentrations. After one year of interdisciplinary therapy, the adolescents presented significant reductions in body weight, total body fat (%), visceral and subcutaneous fat and HOMA-IR, as well as a significant increase of fat free mass (%). Our results may suggest that habitual H-GI diet could upregulate orexigenic pathways, contributing to vicious cycle between undesirable diets, deregulates energy balance and predispose to obesity. One the other hand, one year of interdisciplinary therapy can significant improves metabolic profile and central obesity in adolescents.