Although the effects of aerobic exercise on resting heart rate, heart rate variability, and blood pressure have been investigated, there are scant data on the effects of aerobic exercise on the circadian rhythm of such cardiovascular parameters. In this study, we investigated the effects of aerobic exercise on the 24 h rhythm of heart rate and ambulatory blood pressure in the morning, when cardiovascular events are more common. Thirty-five healthy young subjects were randomized to control and aerobic exercise groups. Subjects in the latter group participated in their respective exercise program for two months, while those in the former group did not exercise. Twenty-four-hour electrocardiogram and ambulatory blood pressure monitoring data were obtained at baseline and at the end of the exercise intervention. The control group showed no changes, while the aerobic exercise group showed a significant decrease in heart rate (73.7 +/- 6.6 bpm to 69.5 +/- 5.1 bpm, p < 0.005) and sympathetic activity such as LF/HF ratio (2.0 +/- 0.7 to 1.8 +/- 0.6, p < 0.05) throughout the 24 h period, particularly in the daytime. The decrease in the heart rate was most prominent in the morning. However, heart rate and LF/HF ratio showed no statistical changes during the night. No significant changes were observed in blood pressure. These findings suggest aerobic exercise exerts beneficial effects on the circadian rhythm of heart rate, especially in the morning.
OBJECTIVE -The aim of this study was to assess the reliability and validity of an evaluation scale for self-management behavior related to physical activity of type 2 diabetic patients (ES-SMBPA-2D).RESEARCH DESIGN AND METHODS -Outpatients with type 2 diabetes (n ϭ 146) completed a self-administered questionnaire supported by a semistructured interview based on a literature review. The content, factor, and concurrent validity and internal consistency and reproducibility of the scale were analyzed. Pearson's correlation coefficients for the ES-SMBPA-2D and International Physical Activity Questionnaire (IPAQ) subscale scores were calculated to evaluate the concurrent validity.RESULTS -The ES-SMBPA-2D was divided into two parts, the first dealing with selfmanagement behavior to enhance physical activity in daily life and the second with behavior to maintain the level of physical activity. Factor analysis showed that the first part comprised four factors and the second five. The ES-SMBPA-2D correlated with the IPAQ subscales. Cronbach's ␣ coefficient was between 0.56 and 0.90, and the intraclass test-retest correlation coefficient of the subscales was between 0.60 and 0.88.CONCLUSIONS -The ES-SMBPA-2D is reasonably reliable and valid and is expected to prove useful for the assessment of patients' self-management behavior and for individualized instruction.
Diabetes Care 30:2843-2848, 2007R egular physical activity is recommended for type 2 diabetic patients, as it is commonly known to improve metabolic disorders and prevent complications such as cardiovascular disease (1). Even moderately intense physical activity through daily activities is beneficial for management of this condition (2,3). However, many patients fail to achieve the recommended level of physical activity (4) because of barriers such as the commonly given reason of "perceived difficulty in exercising" (5). The aim of self-management education is to enable patients to acquire knowledge and skills to improve their diabetic state, identify barriers that hinder improvement, and attain problem-solving and coping skills to achieve effective self-care behavior (6). Thus, medical personnel need to provide patients with strategies to enhance and maintain the required level of physical activity.Self-management education also involves individualized instruction, based on assessment of patients' psychosocial factors and self-management skills and behaviors (7) and strategies to enhance and maintain the required level of physical activity. Most scales designed for this purpose evaluate environmental and psychosocial factors (8 -11), the frequency of diabetes self-care behaviors (12), and perceived adherence to patients' self-care recommendations (13). No tools exist, however, to evaluate self-management behavior related to patients' physical activity. Therefore, the aim of this study was to develop an evaluation scale for selfmanagement behavior related to physical activity of type 2 diabetic patients (ES-SMBPA-2D).
RESEARCH DESIGN AND METHODS -The EthicsCommitt...
The ameliorating effect of α-GI on post-prandial hyperglycemia without stimulating insulin secretion may improve atherogenic dyslipidemia by reducing insulin resistance. These effects are associated with its beneficial impact on oxidative stress, consequently leading to an improvement in endothelial dysfunction.
Aim
Pneumonia ranks high among the causes of death worldwide. However, the predictive values of activities of daily living, the nutrition index and the aspiration index measured objectively remain unclear. The present study aimed to examine the associations of activity, nutrition and dysphagia with pneumonia.
Methods
We assessed 992 hospitalized patients. Logistic regression analysis was used to examine the predictors of pneumonia. Receiver operating characteristic curve analysis was used to determine the cut‐off values of variables. Kaplan–Meier and Cox hazards regression analyses were used to examine the incidence of pneumonia and the factors associated with pneumonia.
Results
We finally enrolled 393 inpatients. Of the 393 patients, 102 (26.0%) had pneumonia. On logistic regression analysis, age, Functional Independence Measure (FIM)‐motor score and Mann Assessment of Swallowing Ability (MASA) score were independent predictors of pneumonia. The FIM‐motor and MASA cut‐off values were 19.5 (area under the curve 0.83, P < 0.01) and 170.5 (area under the curve 0.82, P < 0.01), respectively. Kaplan–Meier analysis showed that the no pneumonia rate was significantly lower among patients with FIM‐motor scores <20 than among those with FIM‐motor scores ≥20 (log–rank test, P < 0.01), and was significantly lower among patients with MASA scores <171 than among those with MASA scores ≥171 (log–rank test, P < 0.01). Cox regression analysis showed that FIM‐motor (hazard ratio 0.97, P = 0.009) and MASA scores (hazard ratio 0.99, P < 0.01) were significantly associated with pneumonia.
Conclusions
In addition to the infectious risk, the FIM‐motor and MASA scales are useful tools to predict the development of pneumonia in older adults. Geriatr Gerontol Int 2018; 18: 1620–1624.
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