Double diabetes (DD) refers to patients with type 1 diabetes who have developed insulin resistance. The objective of this review is to update relevant information on the prescription of physical activity, pharmacological adjustments and consumption of carbohydrates in DD. A systematic search for scientific articles was carried out in the following databases: PubMed, Cochrane, EBSCO, WoS, ScienceDirect and Medline. The evidence analyzed shows that both physical activity (PA) and physical exercise (PE) are essential to achieve metabolic control in people with DD. Physiological considerations such as: insulin adjustments, insulin injection sites, time to perform PA and PE, absolute and relative contraindications are essential to avoid complications, especially hypoglycemia.
Chronic musculoskeletal conditions cause pain and disability and have significant impact on morbidity worldwide. Tele-rehabilitation is proposed as an alternative or complement to improve patient's muscle function, pain, and quality of life. However, the satisfaction of both patients and professionals must be assessed, together with the patient's daily life activity independence. A search of the literature was made to locate assessment reports, systematic reviews and reports from regulatory bodies with support from a documentarian from the Andalusian Health Technologies Assessment Area (AETSA). For this purpose, the following sources were used: Medline, EMBASE, INAHTA (international network of health technologies assessment) and PEDro (Physiotherapy Evidence Database) from 2014 onwards. Subsequently a secondary search was carried out on the articles selected in the initial search. A search of open clinical trials was also carried out in the database: www.ClinicalTrials.gov
Initially 345 articles were identified. Duplicated articles (57) were excluded. By first analysing the title and abstract 238 articles were excluded. The full texts of the remaining 30 articles were analysed. Finally 18 articles were included.
Lung transplant (LT) is the ultimate option for end-stage lung diseases. Malnutrition and sarcopenia, common in LT recipients, can be reversible with adequate exercise and nutrition. This study aims to assess changes in physical performance and aerobic capacity after a 10-week rehabilitation program (RP) in LT recipients, as well as to describe the prevalence of sarcopenia and malnutrition before and after RP and their influence on clinically relevant outcomes.
Quasi-experimental study, before and after a 10-week PR in first-time TP recipients, aged over 18 years, from January 2022 to September 2023. Aerobic exercise capacity was assessed through the 6-minute walking test (6MWT) and peak oxygen consumption (VO2peak); and physical performance was measured using the Short Physical Performance Battery (SPPB). Additionally, the prevalence of sarcopenia was described according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2) and malnutrition according to the criteria of the Global Leadership Initiative on Malnutrition (GLIM).
Of the 41 patients, 56% had sarcopenia and 80% had malnutrition. After RP, the distance walked in the 6MWT increased by 66.3 m (p = 0.004) in men and 61 m (p = 0.001) in women. VO2peak increased in men by a mean of 3.1 ml/min/kg (p = 0.024). Physical performance improved significantly in both men and women according to the Short Physical Performance Battery (SPPB), with clinically relevant differences of 1.6 pts (p < 0.001) and 1.2 pts (p = 0.012), respectively. The prevalence of sarcopenia decreased to 24% and malnutrition to 61%.
RP proved to be an effective and safe intervention for LT recipients. In addition to improvements in skeletal muscle strength and exercise capacity, a reduction in the prevalence of sarcopenia and malnutrition was also observed.
Patients with congenital diaphragmatic hernia (CDH) can have up to 40 times more frequency of muskuloskeletal deformities and decreased perception of physical activity tan their pairs. The objective of this study is to evaluate the safety and efficacy of an individualized exercise program in late adolescents and young adults with repaired CDH, as well as a description of their basal status.
Non randomized prospective trial of 13 patients with repaired CDH between 1997-2005. An initial physical exploration and a pre-post assessment of bioimpedance (BIA), dynamometry, maximal inspiratory and expiratory pressure (MIP/MEP), 6-minute walk test (6MWT), physical activity level (IPAQ) and quality of life (QoL) was made. The training program last for 4 weeks. For the statistical analysis, the Student's t test for paired samples and Wilcoxon test were used.
77% (n = 10) were male with a mean age of 19.23 ± 2.13 years. In baseline BIA, 62% (n = 8) had truncal sarcopenia that improved in −0.43 ± 0.58, and P = .016. MIP, MEP, 6MWT and QoL tests increased by −7.27 ± 8.26 cmH2O, P = .008; −11.91 ± 10.20 cmH2O, P = .002; −70.63 ± 17.88 m, P = .001; −42,19 ± 26.79, P = .00 respectively. The IPAQ did not change significantly (P = 0.86), however the time dedicated to muscle strengthening increased. No adverse effects were reported.
A personalized rehabilitation program is safe and could improve the respiratory muscle strength and truncal sarcopenia as well as the submaximal effort capacity in late adolescents and young adults with repaired CDH.