Safety procedures for exercise testing in the scenario of COVID-19: a position statement of the Società Italiana Scienze Motorie e Sportive

Venturelli, Massimo; Cè, Emiliano; Paneroni, Mara; Guazzi, Marco; Lippi, Giuseppe; Paoli, Antonio; Baldari, Carlo; Schena, Federico; Esposito, Fabio

doi:10.1007/s11332-020-00694-8

Cited by 14 publications

(13 citation statements)

References 16 publications

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“…In addition, cleaning and disinfection procedures should be applied in hospital rooms regularly in order to prevent and control the spread of pathogens. Specifically, health services should implement environment restructuring measures (separate equipment, create ground marks and deactivate digital access), provide hand sanitizers or washbasins thoroughly inside facilities, schedule specific cleaning times, schedule training times, encourage the use of individual bottles and observe air conditioning specification with respect to air exchange [ 46 , 47 ].…”

Section: Covid-19: Non-pharmacological Strategiesmentioning

confidence: 99%

COVID-19: Short and Long-Term Effects of Hospitalization on Muscular Weakness in the Elderly

Sagarra‐Romero

Viñas-Barros

2020

IJERPH

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The COVID-19 pandemic has recently been the cause of a global public health emergency. Frequently, elderly patients experience a marked loss of muscle mass and strength during hospitalization, resulting in a significant functional decline. This paper describes the impact of prolonged immobilization and current pharmacological treatments on muscular metabolism. In addition, the scientific evidence for an early strength intervention, neuromuscular electrical stimulation or the application of heat therapy during hospitalization to help prevent COVID-19 functional sequels is analyzed. This review remarks the need to: (1) determine which potential pharmacological interventions have a negative impact on muscle quality and quantity; (2) define a feasible and reliable pharmacological protocol to achieve a balance between desired and undesired medication effects in the treatment of this novel disease; (3) implement practical strategies to reduce muscle weakness during bed rest hospitalization and (4) develop a specific, early and safe protocol-based care of functional interventions for older adults affected by COVID-19 during and after hospitalization.

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Section: Covid-19: Non-pharmacological Strategiesmentioning

confidence: 99%

COVID-19: Short and Long-Term Effects of Hospitalization on Muscular Weakness in the Elderly

Sagarra‐Romero

Viñas-Barros

2020

IJERPH

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“…Because exercise laboratories are indoors with limited ventilation, there are concerns of exposing patients, medical personnel, and exercise participants to high concentration of aerosols with potential airborne infection in the current COVID 19 pandemic. 16 We have shown that portable HEPA filtration can reduce aerosol concentration during exercise and thus potentially reduce the risk of patient-to-staff transmission. Further advantages of portable HEPA filters for aerosol mitigation are ease of use, portability, relatively low cost, and high efficiency.…”

Section: Discussionmentioning

confidence: 97%

Mitigation of Aerosols Generated During Exercise Testing With a Portable High-Efficiency Particulate Air Filter With Fume Hood

Garzona-Navas

Sajgalik

Csécs

et al. 2021

Chest

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Background The role of portable high-efficiency particulate air (HEPA) filters for supplemental aerosol mitigation during exercise testing is unknown and might be relevant during COVID-19 pandemic. Research Question What is the effect of portable HEPA filtering on aerosol concentration during exercise testing and its efficiency in reducing room clearance time in a clinical exercise testing laboratory? Study Design and Methods Subjects were six healthy volunteers aged 20 to 56 years. In the first experiment, exercise was performed in a small tent with controlled airflow with the use of a stationary cycle, portable HEPA filter with fume hood, and particle counter to document aerosol concentration. Subjects performed a four-stage maximal exercise test that lasted 12 min plus 5 min of pretest quiet breathing and 3 min of active recovery. First, they exercised without mitigation then with portable HEPA filter running. In a separate experiment, room aerosol clearance time was measured in a clinical exercise testing laboratory by filling it with artificially generated aerosols and measuring time to 99.9% aerosol clearance with heating, ventilation, and air conditioning (HVAC) only or HVAC plus portable HEPA filter running. Results In the exercise experiment, particle concentrations reached 1,722 ± 1,484/L vs 96 ± 124/L ( P < .04) for all particles (>0.3 μm), 1,339 ± 1,281/L vs 76 ± 104/L ( P < .05) for smaller particles (0.3 to 1.0 μm), and 333 ± 209/L vs 17 ± 19/L ( P < .01) for larger particles (1.0 to 5.0 μm) at the end of the protocol in a comparison of mitigation vs portable HEPA filter. Use of a portable HEPA filter in a clinical exercise laboratory clearance experiment reduced aerosol clearance time 47% vs HVAC alone. Interpretation The portable HEPA filter reduced the concentration of aerosols generated during exercise testing by 96% ± 2% for all particle sizes and reduced aerosol room clearance time in clinical exercise testing laboratories. Portable HEPA filters therefore might be useful in clinical exercise testing laboratories to reduce the risk of COVID-19 transmission.

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“…During the experimental procedures, they were asked to abstain from alcohol, caffeine or similar beverages in the 24 h preceding the test, as well as to refrain from any form of vigorous physical activity. All the experiments were performed following the safety procedure for exercise testing in the scenario of COVID-19 [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Passive stretching decreases muscle efficiency in balance tasks

et al. 2021

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The current study aimed to verify whether or not passive static stretching affects balance control capacity. Thirty-eight participants (19 women and 19 men) underwent a passive static stretching session, involving the knee extensor/flexor and dorsi/plantarflexor muscles, and a control session (no stretching, CTRL). Before (PRE), immediately after (POST), after 15 (POST15) and 30 min (POST30) from stretching (or rest in CTRL), balance control was evaluated under static and dynamic conditions, with open/closed eyes, and with/without somatosensory perturbation (foam under the feet). During tests, centre of pressure (CoP) sway area and perimeter and antero-posterior and medio-lateral sway mean speed were computed. Surface electromyography root mean square (sEMG RMS) was calculated from the vastus lateralis, biceps femoris, gastrocnemius medialis, and tibialis anterior muscles during MVC and during the balance tests. Hip flexion/extension and dorsi/plantarflexion range of motion (ROM), maximum voluntary contraction (MVC) and sEMG RMS during MVC were measured at the same time points. After stretching, ROM increased (≈6.5%; P<0.05), while MVC and sEMG RMS decreased (≈9% and ≈7.5%, respectively; P<0.05). Regardless of the testing condition, CoP sway area and the perimeter remained similar, while antero-posterior and medio-lateral sway mean speed decreased by ≈8% and ≈12%, respectively (P<0.05). sEMG RMS during the balance tests increased in all muscles in POST (≈7%, P<0.05). All variables recovered in POST30. No changes occurred in CTRL. Passive static stretching did not affect the overall balance control ability. However, greater muscle activation was required to maintain similar CoP sway, thus suggesting a decrease in muscle efficiency.

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Safety procedures for exercise testing in the scenario of COVID-19: a position statement of the Società Italiana Scienze Motorie e Sportive

Cited by 14 publications

References 16 publications

COVID-19: Short and Long-Term Effects of Hospitalization on Muscular Weakness in the Elderly

COVID-19: Short and Long-Term Effects of Hospitalization on Muscular Weakness in the Elderly

Mitigation of Aerosols Generated During Exercise Testing With a Portable High-Efficiency Particulate Air Filter With Fume Hood

Passive stretching decreases muscle efficiency in balance tasks

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