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Impact of Exercise Training on Depression among People with Type 2 Diabetes Mellitus: A Narrative Review

KUTTY, N.A.M
PILLAI, D.R
2020

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Purpose: The prevalence of clinically relevant depressive symptoms among clients with Type 2 diabetes mellitus is in the range of 30%. Since these conditions are often under-diagnosed and under-treated in clinical practice, they negatively affect functional recovery, adherence to treatment, and the quality of life. Despite the large body of evidence regarding the effects of exercise training on different aspects of diabetes, no updated conclusive article that reviews depression is available. This article aims to review the current literature on exercise training and its effect on depression in people with Type 2 diabetes mellitus.

 

Method: An electronic search of literature from 2010, highlighting the effects of exercise on depression among Type 2 diabetes mellitus clients, was conducted using Google Scholar and PubMed.  Relevant articles were utilised for this review.  The selected studies are based on relational and rehabilitative exercise training approaches.

 

Results: While most of the studies support the efficacy of exercise training, study settings and described models are not conclusive.  No single clearly defined model exists for exercise training for depression among people with diabetes. There is evidence for the efficacy of supervised aerobic exercise in the treatment of depression, when undertaken three times weekly at moderate intensity, for a minimum of eight weeks. Further research is required to develop specific exercise training models that can be tested in experimental studies for this client group.

 

Conclusion: The current review showed that exercise training can be used to alleviate depression among people with diabetes. Future studies should adopt rigorous methodological criteria to back up the present findings.

National approaches to promote sports and physical activity in adults with disabilities: examples from the Netherlands and Canada

HOEKSTRA, Femke
ROBERTS, Lynn
VAN LINDERT, Caroline
MARTIN GINIS, Kathleen A
VAN DER WOUDE, Lucas H V
MCCOLL, Mary Ann
January 2018

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Purpose: This study described how the Dutch and Canadian governments promote high performance sports, recreational sports, and physical activity (PA) among adults with disabilities on a national level.

 

Methods: An internet-based study was conducted to identify and select relevant documents and websites containing information about the national approach to promote disability sports and physical activities in the Netherlands and Canada.

 

Results: Both governments promote high performance sports in similar ways, but use different strategies to promote recreational sports and physical activities. The Dutch approach is characterized by using time-limited programs focusing on enhancement of sports infrastructure and inter-sector collaboration in which municipalities have key roles. The Canadian government promotes recreational sports in disabled populations by supporting programs via bilateral agreements with provinces and territories. Furthermore, the level of integration of disability sports into mainstream sports differs between countries.

 

Conclusions: The findings of this study may inspire policy makers from different countries to learn from one another’s policies in order to optimize national approaches to promote disability sports and PA on all levels.

Fatigue and Functional Capacity in Persons with Post-Polio Syndrome: Short-term Effects of Exercise and Lifestyle Modification Compared to Lifestyle Modification Alone

SHARMA, S S
SHETH, M S
VYAS, N J
2014

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Purpose: Post-polio Syndrome (PPS) affects polio survivors many years after the initial attack, and causes new musculoskeletal symptoms and decline in physical function. This study aims to compare the effect of exercise and lifestyle modification versus lifestyle modification alone, on fatigue and functional capacity in persons with PPS.

 

Method: An experimental study was conducted at the physiotherapy department of VS Hospital in Ahmedabad. As per the criteria of Halstead (1985), 21 PPS subjects who were between 18 and 65 years of age, and able to walk indoors and outdoors, with or without assistive aids, were included. They were randomly allocated into 3 groups using the envelope method. Those with physician- diagnosed respiratory or cardiac insufficiency, disabling co-morbidity which interfered with the intervention programme or influenced the outcome, and those unable to cooperate due to cognitive impairment or use of any psychotropic drugs, were excluded. Fatigue and functional capacity were measured using Fatigue Severity Scale (FSS) and 2-minute walk distance, respectively. Physical and psychological functions were assessed using Patient Reported Outcome Measurement Information System (PROMIS) questionnaire and Patient Health Questionnaire (PHQ-9) respectively. Intervention was given for 5 days a week, over 4 weeks. Group A received exercise and lifestyle modification, group B received lifestyle modification alone and group C continued their usual routine for 1 month.

 

Results: There was a significant difference in fatigue and functional capacity within groups A and B, with group A showing better reduction in fatigue than groups B or C. Physical function improved only within group A, and a significant difference was seen compared to groups B and C. Psychological function showed no difference within or between the groups.

 

Conclusion: There was improvement in fatigue, functional capacity and physical function in PPS subjects after 4 weeks of exercise and lifestyle modification. Lifestyle modifications alone for 4 weeks improved fatigue and functional capacity in PPS subjects. There is significant reduction in fatigue and improvement in functional capacity when lifestyle modification advice is given along with exercise.

Effects of Multisensory Training on Balance and Gait in Persons with Type 2 Diabetes: A Randomised Controlled Trial

KUTTY, N A M
MAJIDA, N A
2013

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Purpose: Progressive deterioration of physical function occurs in persons with Type 2 diabetes and peripheral neuropathy. This study assessed the effects of multisensory training on balance and gait in persons with diabeticneuropathies.

 

Method: Thirty two persons with peripheral neuropathies were enrolled, randomised, and subdivided into 2 groups - an experimental group of 16 participants with diabetes (65 ± 2.12 years) and a control group of 16 participants with diabetes (68 ± 2.17 years). For 6 weeks, both groups were given health education on diabetes for 30 minutes a week. In addition, the experimental group practised a multisensory exercise programme for 30 minutes, 3 times a week over 6 weeks. Outcome measures used were ‘timed up and go’ test for assessing balance and ‘6-minute walk’ test for gait. Standard descriptive statistics were used to report means, standard deviation, and range for baseline characteristics. Paired and unpaired ‘t-tests’ were used wherever necessary, to determine significant differences in data among groups and between pre-test and post-test scores (p<0.05).

 

Results: By the end of the trial period, the intervention group showed a significant improvement in scores of the ‘timed up and go’ test (t= 14.7092), but there was no statistically significant difference in the ‘6-minute walk’ test scores (p=0.7206, t= 0.3644).There was no difference for both measures in the control group.

 

Conclusion: The study showed that multisensory exercises could improve balance in persons with Type 2 diabetes and peripheral neuropathy. The findings suggest that along with physiological sensory factors, cognitive-behavioural factors and strengthening of the lower limb muscles should be considered when treating diabetic persons with gait alterations.

Shoulder Pain among Rehabilitated Spinal Cord Injured Persons Using Manually Propelled Wheelchairs in the Gaza Strip: A Survey

EL ESSI, K
EL-SHAFIE, J M
AL HAWAMDAH, Z
ZAQOUT, S I
2012

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Shoulder pain among paraplegic persons has negative effects on their lives. The prevalence of shoulder pain among persons with spinal cord injury (SCI) varies from 30% to 70% in different studies and may be related to repetitive use of the shoulder during self-care and wheelchair-related activities.

 

Purpose: This study focused on the prevalence of shoulder pain and examined its effects on activities of daily living and social participation, and on functional, work and recreational or athletic activities. It also aimed to detect the degree ofsatisfaction with shoulder functioning in wheelchair users who were paraplegic due to spinal cord injury, in the Gaza strip.

 

Methods: Cross sectional study design was used to collect data from 80 persons with paraplegia, post rehabilitation, who were still using manual wheelchairs (MWC) for ambulation. After giving informed consent, the selected persons were interviewed directly in their homes, and filled questionnaires which included demographic data, Wheelchair User’s Shoulder Pain Index (WUSPI) and Shoulder Rating Questionnaire (SRQ).

 

Results: The prevalence rate of shoulder pain among paraplegics who use manual wheelchairs was 62%. Pushing a wheelchair for 10 minutes or more, and propulsion up ramps or inclines outdoors were the most common activities that caused and exacerbated shoulder pain. Sixty four percent from among the study sample mentioned that they had no limitation in shoulder-using ability during daily personal and household activities, while the rest experienced different degrees of limitation. Seventy-four percent reported no limitation during recreational or athletic activities, while the rest (26%) agreed that pain has variably limited their participation in these activities. Fourteen percent from the sample rated the overall degree of satisfaction with their shoulder functioning as fair, and the rest rated their satisfaction from good to excellent.

 

Conclusion: Shoulder pain, ranging from mild to severe, was highly prevalent among SCI paraplegics who use MWCs during their usual activities, and other activities which involve wheelchair propulsion. About two- thirds of the subjectsreported no limitation in shoulder use during daily personal and household activities and in recreational or athletic activities.

Manual for the professional in adapted physical activity

PEYNOT, Lucile
CHANTEREAULT, Thomas
BOUZID, Ezzedine
June 2011

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The focus of this manual is to increase participation of people with disabilities in physical activities and sport. Detailed adapted physical activities are provided with practical guides, group sport guides and assessment tools in order to promote a more inclusive society and enable educators to enrich their creativity and ideas for mentoring any person interested in participating in, advancing through and gaining enjoyment from the practice of a physical activity This guide to useful to all actors such as physical education and sports teachers in all types of schools, sports club coaches, recreational centre educators and facilitators, and even workers in rehabilitation centres or medical and social services centres

Popular theater [Chapter 48]

WERNER, David
2009

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This chapter presents information about how community theater can be used to raise awareness about specific needs of disabled persons or to gain greater participation of local people in a community rehabilitation programme. It also highlights that community theatre can be a good method for educating people about important preventive measures and recommends that actors can be disabled persons, parents of disabled children, health workers, rehabilitation workers, schoolchildren, or any combination of these
Chapter 48 of "Disabled Village Children" by David Warner

Playgrounds for all children [Chapter 46]

WERNER, David
2009

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This chapter presents information about how to involve local people in building low-cost rehabilitation playgrounds that should be built for use by all children, both disabled and non-disabled. Examples of playgrounds and equipment are provided
Chapter 46 of "Disabled Village Children" by David Warner

Laugh, run, and move to develop together : games with a psychosocial aim

MEUWLY, Michèle
HEINIGER, Jean-Pierre
2007

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This manual was created following a project initiated by Terre des Hommes called "Movement, Games and Sport for children’s psychosocial development". The manual, a compilation of twenty games, provides a play tool which integrates the psychosocial approach and uses the phases of learning by experience

The HELP guide for community based rehabilitation workers : a training manual

LOVEDAY, Marion
2006

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This is a training manual for community based rehabilitation workers based upon physiotherapist's work on a rehabilitation project in Cape Town, South Africa. The manual is aimed at trainers of rehabilitation workers who are assumed to have adequate medical knowledge. The manual is divided into the following 4 main topics: health in the community; normal body functions; conditions and treatment; management of patients. Each section contains a summary of the learning aims for the rehabilitation workers, and the teaching is based mainly on a question and answer format
Note: originally published in 1990 by SACLA Health Project

Making a hero book : a guide for facilitators

MORGAN, Jonathan
2003

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This manual describes one of the tools used in "memory work", an approach to helping families and communities cope with HIV and AIDS. Through a series of art exercises and storytelling, children are encouraged to identify their heroes or role models. This process should help children affected by HIV/AIDS to cope with emotions (sadness, fear, anger), and to develop resilience and a positive approach to life. Through the process of developing a book, children are also encouraged to see themselves as heroes, to rely on their strengths and maximise their potential to overcome the problems they might encounter

Music therapy and leisure for persons with disabilities

BARKSDALE, Alicia L
2003

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This book explores the use of music therapy in school and community settings to enhance the development of independent leisure skills with a variety of client populations, including children, adolescents, adults, and the elderly with mental health needs, developmental and learning disabilities, Alzheimer’s disease and other aging-related conditions, substance abuse problems, brain injuries, and physical disabilities

Helping children who are blind : family and community support for children with vision problems|Ayudar a los niños ciegos : apoyo familiar y comunitario para niños con problemas de la vista

NIEMANN, Sandy
JACOB, Namita
2000

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Children develop faster in the first five years of life than any other time, and children who are blind need extra help so they can learn how to use their other senses to explore, learn and interact with the world. The simple activities in this book can help families, health workers, and individuals to support children with vision impairment to develop their capabilities. Topics include: assessing how much a child can see; preventing blindness; helping a child move around safely; activities of daily living; preparing for childcare or school; and supporting the parents of blind children. The book is written in an easy-to-read style with illustrations and examples from southern countries

Helping health workers learn : a book of methods, aids, and ideas for instructors at the village level

WERNER, David
BOWER, Bill
1998

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This book on community health education provides a people-centered approach to health care and presents strategies for effective community involvement through participatory approaches. It discusses methods and experiences from at least 35 countries are discussed, focusing on the educational rather than medical. Activities suggested for the most effective and enjoyable community education include theatre, drawing, flannel boards, and other low-cost, popular teaching aids. It contains many illustrations, and is written in an accessible style

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