METHODS: Sixty NAFLD patients (32 males, 28 females; age: 49.7±8.7 years; BMI: 31.1±3.3 kg/m2) were randomized into HIIT, aerobic training, and control cohorts. The HIIT cohort performed 4-minute high-intensity intervals at 85-95% of peak heart rate, interspersed with 3-minute active recovery at 60-70% of peak heart rate for 30-40 minutes per session. The aerobic training cohort performed continuous exercise at 60-70% of peak heart rate for 45-60 minutes per session. Both intervention cohorts underwent 12 weeks of supervised training, thrice weekly. Before and after the intervention, assessments included cardiorespiratory fitness, muscular strength, flexibility, lipid profile, liver enzymes, inflammatory markers, insulin sensitivity, and oxidative stress markers.
RESULTS: Compared to controls, both exercise cohorts showed significant improvements in cardiorespiratory fitness, muscular strength, and flexibility. However, HIIT elicited superior enhancements in cardiorespiratory fitness and muscular strength. Biochemically, both exercise cohorts exhibited reductions in triglycerides, low-density lipoprotein (LDL) cholesterol, liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST]), inflammatory markers (C-reactive protein [CRP], interleukin-6 [IL-6]), insulin resistance (homeostatic model assessment of insulin resistance [HOMA-IR]), and oxidative stress markers (malondialdehyde [MDA], protein carbonyl). Notably, HIIT yielded more substantial improvements in these parameters.
CONCLUSIONS: HIIT and traditional aerobic training are effective in improving physical fitness and ameliorating biochemical indicators in NAFLD patients. Notably, HIIT appears to be more advantageous in enhancing cardiorespiratory fitness, muscular strength, and metabolic, inflammatory, and oxidative stress profiles, suggesting its potential as a time-efficient and effective exercise modality for managing NAFLD.
METHOD: Prospective cohort study of all parents of children with bilateral non-ambulant CP who owned Android devices. NeuroPAIN app was installed in all participants. At 3-month follow-up, data of the NeuroPAIN app was analyzed and participants were given a feedback questionnaire to complete.
RESULTS: Total of 60 parents participated in the study (child's median age 7 years, interquartile range 4-8.75 years). The vast majority (95 %) of parents reported pain in their children. Children with assisted tube feeding was associated with reported increased pain frequency. Majority (77 %) felt it was easy to navigate the NeuroPAIN app. Two-thirds regularly tracked their child's pain using the app over a 2-month period. Parents of children with prolonged periods of pain ≥25 s were associated with reduced app usage.
CONCLUSION: Majority of Malaysian children with bilateral CP often experience pain particularly among those with assisted tube feeding highlighting the importance for clinicians to be vigilant in monitoring pain among these children. Prolonged pain periods among children with CP may lead to parental fatigue in monitoring pain through the NeuoPAIN app.
OBJECTIVE: This study aimed to evaluate the effect of tugging of the Foley balloon for 30 seconds every 3 hours during 12 hours of scheduled placement in comparison with standard care (no tugging) on the induction to birth interval and patient satisfaction.
STUDY DESIGN: This randomized controlled trial, conducted at a university hospital in Malaysia, recruited participants from April 2023 to March 2024. Eligible participants admitted for Foley balloon induction of labor who had 1 previous cesarean were recruited. After balloon insertion, participants were randomized to tugging or standard care. Following balloon displacement, a vaginal examination was performed to check the cervix. The examination findings then dictated the follow-on management of induction of labor after 1 previous cesarean according to standard practice. The primary outcomes were the induction (Foley insertion) to delivery interval and participants' satisfaction with the birthing process. Secondary outcomes were largely derived from the core outcome set for trials on induction of labor. Based on a superiority hypothesis, it was calculated that a sample size of 126 would be required to detect a 4-hour reduction in the induction-to-delivery interval and a 1.5 point increase in the satisfaction score based on a 0 to 10 numerical rating scale with the level of significance set at 0.05, power at 80%, and a 10% drop out rate. Comparative analyses using an intention-to-treat approach were conducted using t tests, Mann-Whitney U tests, chi square tests, and Fisher exact tests as appropriate.
RESULTS: A total of 126 participants were randomized with 63 in each trial arm. The induction to birth interval was (mean ± standard deviation) 29.7±9.6 hours for those in the 3-hourly tugging group and 29.8±9.1 hours for those under standard care (P=.950), and maternal satisfaction with the induction of labor after 1 previous cesarean delivery birth process, assessed using a 0 to 10 numerical rating scale, was (median [interquartile range]) 8 [7-9] and 8 [7-9] (P=.936), respectively. The cesarean delivery rate was 37 of 63 (59%) vs 41 of 63 (65%) (P=.238) for those in the tugging group vs standard care, and the main indication for unplanned cesarean delivery was failure to progress with an incidence of 24 of 37 (65%) and 24 of 41 (59%) (P=.914) for tugging vs standard care arms, respectively. Three-hourly tugging also did not shorten the interval from induction to balloon displacement, amniotomy, the start of oxytocin infusion, or the second stage of labor.
CONCLUSION: Tugging the catheter every 3 hours during scheduled 12-hour Foley balloon placement for induction of labor after 1 previous cesarean delivery did not hasten birth or improve patient satisfaction when compared with standard care.