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Article: Defining and reporting exercise intensity in interventions for older adults: a modified Delphi process.

Wollesen, Bettina / Herden, Mona / Lamberti, Nicola / Giannaki, Christoforos D

European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity

2024 Volume 21, Issue 1, Page(s) 3

Abstract: Background: Many exercise studies, including older adults, do not report all relevant exercise characteristics. Especially the description of exercise intensity is missing and mostly not controlled. This leads to difficulties in interpreting study ... ...

Abstract	Background: Many exercise studies, including older adults, do not report all relevant exercise characteristics. Especially the description of exercise intensity is missing and mostly not controlled. This leads to difficulties in interpreting study results and summarizing the evidence in systematic reviews or meta-analyses. Therefore, the aim of the present Delphi study was to gain recommendations about the categorization of exercise intensity and for the conducting and reporting of characteristics in future intervention studies with older adults by experts in exercise science and physiology. Methods: Two hundred ninety-seven international interdisciplinary participants from an EU COST action were invited to participate in three rounds of online questionnaires in April/May 2023. Up to N = 93 experts participated in each round. Round 1 included open-ended questions to solicit possible recommendations and categorizations for light, moderate, vigorous, and high intensity. In round 2, the experts rated their agreement using Likert scales (1-10) on the revealed categories and recommendations. Clusters with a higher average rating of M = 8.0 were summarized into round 3. In the final round, the results were presented for a final rating of agreement (based on a simple majority > 50%). Results: In round 1 a total of 416 qualitative statements were provided from thirteen questions. From round 1 to round 3, a total of 38 items were excluded, with 205 items retained for the final consensus. In round three 37 participants completed the whole questionnaire. The experts showed overall agreement on the final categorizations with 6.7 to 8.8 out of 10 points on the Likert scale. They also showed broad consensus on the relevance of reporting exercise intensity and the recommendations for future conducting and reporting of study results. However, exercise types such as yoga, balance, and coordination training led to conflicting results for categorization into light or moderate. Discussion and implications: The results of the current survey can be used to classify the intensity of exercise and suggest a practical approach that can be adopted by the scientific community and applied when conducting systematic reviews and meta-analysis articles when vital and objective information regarding exercise intensity is lacking from the original article.
Language	English
Publishing date	2024-02-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2236925-9
ISSN	1861-6909 ; 1813-7253
ISSN (online)	1861-6909
ISSN	1813-7253
DOI	10.1186/s11556-024-00337-8
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Article: Exercise-based functional recovery from severe upper extremity arterial disease due to bilateral subclavian artery obstruction in a person with giant cell arteritis.

Manfredini, Fabio / Zenunaj, Gladiol / Traina, Luca / Gasbarro, Vincenzo / Lamberti, Nicola

Journal of vascular surgery cases and innovative techniques

2023 Volume 9, Issue 2, Page(s) 101179

Abstract: We report the case of a 71-year-old woman diagnosed with giant cell arteritis with bilateral subclavian and axillary obstruction and severe arm claudication that occurred 3 months earlier and was non-regressed after corticosteroids. Before possible ... ...

Abstract	We report the case of a 71-year-old woman diagnosed with giant cell arteritis with bilateral subclavian and axillary obstruction and severe arm claudication that occurred 3 months earlier and was non-regressed after corticosteroids. Before possible revascularization, the patient was initiated to a personalized home-based graded exercise program including walking, hand-bike pedaling, and muscle strength training. During the 9 months of treatment, the patient progressively improved radial pressure values (10 to 85 mmHg), hand temperature values by infrared-thermography (+2.1 °C), arm endurance, and forearm muscle oxygenation by near-infrared spectroscopy. Home-based graded exercise proved to be a noninvasive option for upper limb claudication.
Language	English
Publishing date	2023-04-07
Publishing country	United States
Document type	Case Reports
ISSN	2468-4287
ISSN	2468-4287
DOI	10.1016/j.jvscit.2023.101179
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Article ; Online: A "test in-train out" program versus a "go home and walk" intervention for home-based exercise therapy in patients with peripheral artery disease: A randomized controlled trial.

Manfredini, Fabio / Traina, Luca / Ficarra, Valentina / Gandolfi, Giorgio / Argentoni, Antonio / Straudi, Sofia / Gasbarro, Vincenzo / Lamberti, Nicola

Scandinavian journal of medicine & science in sports

2024 Volume 34, Issue 2, Page(s) e14584

Abstract: Objective: In this single-blinded randomized controlled trial, we compared the "Test in-Train Out" structured home-based exercise program (TiTo-SHB) with the traditional "go home and walk" exercise intervention in people with peripheral artery disease ( ... ...

Abstract	Objective: In this single-blinded randomized controlled trial, we compared the "Test in-Train Out" structured home-based exercise program (TiTo-SHB) with the traditional "go home and walk" exercise intervention in people with peripheral artery disease (PAD). Methods: Peripheral artery disease patients at Leriche-Fontaine's stage II were randomized to receive TiTo-SHB or walking advice (C-WA). The TiTo-SHB group performed two daily 8-min sessions of pain-free interval walking at progressive low-to-moderate speed maintained with a metronome. The C-WA group was recommended to walk for 30 min at least three times per week and to endure claudication pain. Outcomes collected at baseline and at the end of the program (6 months) included: 6-min and pain-free walking distance (6MWD, PFWD), ankle-brachial index (ABI), 5-time sit-to-stand test (5STS), and health-related quality of life (HRQoL) by the VascuQoL-6 questionnaire. Results: A total of 68 patients were randomized (males n = 50; aged 73 ± 9; TiTo-SHB n = 34). At the end of the program, patients in the TiTo-SHB group compared with the C-WA group had significantly improved 6MWD (Δ + 60 ± 32 m vs. Δ - 5 ± 37 m; p < 0.001) and PFWD (Δ + 140 ± 92 m vs. Δ - 7 ± 87 m; p < 0.001). A significant between-group difference in favor of the TiTo-SHB group was also recorded for all the secondary outcomes, including 5STS (Δ - 2.6 ± 1.8 s vs. Δ + 0.8 ± 2.6 s; p < 0.001), ABI of the more impaired limb (Δ + 0.10 ± 0.11 vs. Δ + 0.02 ± 0.08; p = 0.003), and VascuQoL-6 score (Δ +2 ± 2 vs. -1 ± 4; p < 0.001). Conclusion: In PAD patients with claudication, the pain-free in-home TiTo-SHB program was more effective in improving exercise capacity and HRQoL than the traditional walking advice recommendation.
MeSH term(s)	Male ; Humans ; Female ; Quality of Life ; Peripheral Arterial Disease/therapy ; Intermittent Claudication/therapy ; Walking ; Exercise Therapy ; Treatment Outcome ; Walk Test
Language	English
Publishing date	2024-02-22
Publishing country	Denmark
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1077418-x
ISSN	1600-0838 ; 0905-7188
ISSN (online)	1600-0838
ISSN	0905-7188
DOI	10.1111/sms.14584
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Article: Clinically-driven design of novel methods of investigation on skeletal health status in neurological disorders. The case of the traumatic brain injuries.

Penolazzi, Letizia / Straudi, Sofia / Lamberti, Nicola / Lambertini, Elisabetta / Bianchini, Chiara / Manfredini, Fabio / Piva, Roberta

Frontiers in neurology

2023 Volume 14, Page(s) 1176420

Language	English
Publishing date	2023-05-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1176420
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Article ; Online: [Physical exercise in chronic kidney disease: an empty narrative or an effective intervention?]

Battaglia, Yuri / Lamberti, Nicola / Piva, Giovanni / Manfredini, Fabio / Storari, Alda

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia

2021 Volume 38, Issue 6

Abstract: Chronic kidney disease (CKD) is growing worldwide, with increasing numbers of patients facing end-stage renal disease, high cardiovascular risk, disability and mortality. Early recognition of CKD and improvements in lifestyle are crucial for maintaining ... ...

Abstract	Chronic kidney disease (CKD) is growing worldwide, with increasing numbers of patients facing end-stage renal disease, high cardiovascular risk, disability and mortality. Early recognition of CKD and improvements in lifestyle are crucial for maintaining or recovering both physical function and quality of life. It is well known that reducing sedentariness, increasing physical activity and initiating exercise programs counteract cardiovascular risk and frailty, limit deconditioning and sarcopenia, and improve mobility, without side-effects. However, these interventions, often requested by CKD patients themselves, are scarcely available. Indeed, it is necessary to identify and train specialists on exercise in CKD and to sensitize doctors and health personnel, so that they can direct patients towards an active lifestyle. On the other hand, effective and sustainable interventions, capable of overcoming patients' barriers to exercise, remain unexplored. Scientific societies, international research teams and administrators need to work together to avoid that exercise in nephrology remains an empty narrative, a niche interest without any translations into clinical practice, with no benefit to the physical and mental health of CKD patients.
MeSH term(s)	Exercise ; Humans ; Quality of Life ; Renal Insufficiency, Chronic/therapy
Language	Italian
Publishing date	2021-12-16
Publishing country	Italy
Document type	Editorial
ZDB-ID	1237110-5
ISSN	1724-5990 ; 0393-5590
ISSN (online)	1724-5990
ISSN	0393-5590
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Article ; Online: Is robot-assisted gait training intensity a determinant of functional recovery early after stroke? A pragmatic observational study of clinical care.

Lissom, Luc Oscar / Lamberti, Nicola / Lavezzi, Susanna / Basaglia, Nino / Manfredini, Fabio / Straudi, Sofia

International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation

2022 Volume 45, Issue 2, Page(s) 189–194

Abstract: Gait rehabilitation is a critical factor in functional recovery after a stroke. The aim of this pragmatic observational study was to identify the optimal dose and timing of robot-assisted gait training (RAGT) that can lead to a favourable outcome in a ... ...

Abstract	Gait rehabilitation is a critical factor in functional recovery after a stroke. The aim of this pragmatic observational study was to identify the optimal dose and timing of robot-assisted gait training (RAGT) that can lead to a favourable outcome in a sample of subacute stroke survivors. Subacute patients with stroke who underwent a RAGT within a multidisciplinary rehabilitation program were enrolled. A set of clinical (i.e. age, type of stroke and time since stroke) and rehabilitation stay outcomes (length of stay and RAGT number of sessions) were recorded to evaluate their impact on functional outcome measures by functional independence measure (FIM) or functional ambulation category (FAC). We included 236 patients (62.73 ± 11.82 year old); 38.44% were females, and 59.32% were ischaemic stroke patients. Patients that received at least 14 RAGT sessions, had 15.83% more chance to be responders compared to those that receive less sessions (P = 0.006). Similarly, younger patients (≤60 years) were more prone to be responders (+15.1%). Lastly, an early rehabilitation (<6 weeks) was found to be more efficient (+21.09%) in determining responsiveness (P < 0.001). Becoming newly independent for gait, that refers to a FAC score ≥4, was related with age and RAGT sessions (P = 0.001). In conclusion, a younger age (≤60 years), an early rehabilitation (<6 weeks since stroke) and a higher RAGT dose (at least 14 sessions) were related to a favourable outcome in patients with subacute stroke.
MeSH term(s)	Aged ; Brain Ischemia ; Exercise Therapy ; Female ; Gait ; Gait Disorders, Neurologic/rehabilitation ; Humans ; Male ; Middle Aged ; Robotics ; Stroke ; Stroke Rehabilitation
Language	English
Publishing date	2022-02-07
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	533323-4
ISSN	1473-5660 ; 0342-5282
ISSN (online)	1473-5660
ISSN	0342-5282
DOI	10.1097/MRR.0000000000000518
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Article ; Online: The Issue of Gender Bias Represented in Authorship in the Fields of Exercise and Rehabilitation: A 5-Year Research in Indexed Journals.

Rinaldo, Natascia / Piva, Giovanni / Ryder, Suzanne / Crepaldi, Anna / Pasini, Alba / Caruso, Lorenzo / Manfredini, Roberto / Straudi, Sofia / Manfredini, Fabio / Lamberti, Nicola

Journal of functional morphology and kinesiology

2023 Volume 8, Issue 1

Abstract: Despite progress made in recent decades, gender bias is still present in scientific publication authorship. The underrepresentation of women and overrepresentation of men has already been reported in the medical fields but little is known in the fields ... ...

Abstract	Despite progress made in recent decades, gender bias is still present in scientific publication authorship. The underrepresentation of women and overrepresentation of men has already been reported in the medical fields but little is known in the fields of exercise sciences and rehabilitation. This study examines trends in authorship by gender in this field in the last 5 years. All randomized controlled trials published in indexed journals from April 2017 to March 2022 through the widely inclusive Medline dataset using the MeSH term "exercise therapy" were collected, and the gender of the first and last authors was identified through names, pronouns and photographs. Year of publication, country of affiliation of the first author, and ranking of the journal were also collected. A chi-squared test for trends and logistic regression models were performed to analyze the odds of a woman being a first or last author. The analysis was performed on a total of 5259 articles. Overall, 47% had a woman as the first author and 33% had a woman as the last author, with a similar trend over five years. The trend in women's authorship varied by geographical area, with the higher representation of women authors in Oceania (first: 53.1%; last: 38.8%), North-Central America (first: 45.3%; last: 37.2%), and Europe (first: 47.2%; last: 33.3%). The logistic regression models (
Language	English
Publishing date	2023-01-30
Publishing country	Switzerland
Document type	Journal Article
ISSN	2411-5142
ISSN (online)	2411-5142
DOI	10.3390/jfmk8010018
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Article ; Online: Effects of Exercise, Rehabilitation, and Nutritional Approaches on Body Composition and Bone Density in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis.

Rinaldo, Natascia / Pasini, Alba / Straudi, Sofia / Piva, Giovanni / Crepaldi, Anna / Baroni, Andrea / Caruso, Lorenzo / Manfredini, Fabio / Lamberti, Nicola

Journal of functional morphology and kinesiology

2023 Volume 8, Issue 3

Abstract: People with multiple sclerosis (pwMS) are affected by a wide range of disabilities, including a decrease in bone mineral density (BMD) and a worsening of body composition (BC), which negatively impact their quality of life quality. This study aims to ... ...

Abstract	People with multiple sclerosis (pwMS) are affected by a wide range of disabilities, including a decrease in bone mineral density (BMD) and a worsening of body composition (BC), which negatively impact their quality of life quality. This study aims to analyze the effects of nonpharmacological interventions-in particular, physical activity, nutritional approaches, and rehabilitation-on BC and BMD in pwMS. This systematic review and meta-analysis was performed following the updated version of the PRISMA guidelines. In July 2022, five databases (MEDLINE, Embase, The Cochrane Library, Google Scholar, Web of Science) and gray literature were screened. Relevant articles published between 1 January 1990 and 1 September 2022 in any language were included. Outcomes of interest were anthropometric, BC measures, and BMD. The RoB 2.0 tool was used to assess the risk of bias. After duplicates elimination, 1120 records were screened, and 36 studies were included. A total of 25 articles were focused on physical activity and rehabilitation, 10 on nutrition, and 1 on multimodal intervention. One-third of the studies were judged to be at high risk of bias. The meta-analysis showed a high degree of heterogeneity due to the high variability in disease severity and intervention duration, intensity, frequency, and type. In general, no intervention showed consistent positive effects on BC. However, the most promising interventions seemed to be high-intensity training and ketogenic diets. Only a few studies considered BMD, and the results are inconsistent. Nevertheless, more studies are needed in order to confirm these results.
Language	English
Publishing date	2023-09-08
Publishing country	Switzerland
Document type	Journal Article ; Review
ISSN	2411-5142
ISSN (online)	2411-5142
DOI	10.3390/jfmk8030132
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Article ; Online: Variations in Health-Related Quality of Life After Stroke: Insights From a Clinical Trial on Arm Rehabilitation With a Long-Term Follow-Up.

Milani, Giada / Mantovani, Linda / Baroni, Andrea / Lamberti, Nicola / Basaglia, Nino / Lavezzi, Susanna / Manfredini, Fabio / Straudi, Sofia

Advances in rehabilitation science and practice

2023 Volume 12, Page(s) 27536351231214845

Abstract: Despite rehabilitation, stroke patients continue to have impaired function and reduced health-related quality of life (HRQoL) even in a chronic stage. However, no clear information is available on long-term variations in HRQoL. In this study, we aimed to ...

Abstract	Despite rehabilitation, stroke patients continue to have impaired function and reduced health-related quality of life (HRQoL) even in a chronic stage. However, no clear information is available on long-term variations in HRQoL. In this study, we aimed to report the short- and long-term changes in HRQoL in a subacute stroke sample that was enrolled in a clinical trial on arm rehabilitation. Thirty-nine stroke survivors (62% male, mean age 68 years) were assessed using the Stroke Impact Scale Version 2.0 (SIS 2.0) pre and post rehabilitation and at 6 months and 6 years follow-up. Long-term changes in physical function were explored through clinically meaningful changes in the Stroke Impact Scale-16 (SIS-16). After rehabilitation (
Language	English
Publishing date	2023-11-29
Publishing country	England
Document type	Journal Article
ISSN	2753-6351
ISSN (online)	2753-6351
DOI	10.1177/27536351231214845
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Article ; Online: Quantitative Comparison of Hand Kinematics Measured with a Markerless Commercial Head-Mounted Display and a Marker-Based Motion Capture System in Stroke Survivors.

Casile, Antonino / Fregna, Giulia / Boarini, Vittorio / Paoluzzi, Chiara / Manfredini, Fabio / Lamberti, Nicola / Baroni, Andrea / Straudi, Sofia

Sensors (Basel, Switzerland)

2023 Volume 23, Issue 18

Abstract: Upper-limb paresis is common after stroke. An important tool to assess motor recovery is to use marker-based motion capture systems to measure the kinematic characteristics of patients' movements in ecological scenarios. These systems are, however, very ... ...

Abstract	Upper-limb paresis is common after stroke. An important tool to assess motor recovery is to use marker-based motion capture systems to measure the kinematic characteristics of patients' movements in ecological scenarios. These systems are, however, very expensive and not readily available for many rehabilitation units. Here, we explored whether the markerless hand motion capabilities of the cost-effective Oculus Quest head-mounted display could be used to provide clinically meaningful measures. A total of 14 stroke patients executed ecologically relevant upper-limb tasks in an immersive virtual environment. During task execution, we recorded their hand movements simultaneously by means of the Oculus Quest's and a marker-based motion capture system. Our results showed that the markerless estimates of the hand position and peak velocity provided by the Oculus Quest were in very close agreement with those provided by a marker-based commercial system with their regression line having a slope close to 1 (maximum distance: mean slope = 0.94 ± 0.1; peak velocity: mean slope = 1.06 ± 0.12). Furthermore, the Oculus Quest had virtually the same sensitivity as that of a commercial system in distinguishing healthy from pathological kinematic measures. The Oculus Quest was as accurate as a commercial marker-based system in measuring clinically meaningful upper-limb kinematic parameters in stroke patients.
MeSH term(s)	Humans ; Motion Capture ; Biomechanical Phenomena ; Hand ; Upper Extremity ; Movement ; Stroke ; Stroke Rehabilitation
Language	English
Publishing date	2023-09-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s23187906
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