There is increasing knowledge in the recognition of individuals at risk for progression to rheumatoid arthritis (RA) before the clinical manifestation of the disease. This prodromal phase preceding the manifestation of RA may represent a "window of opportunity" for preventive interventions that may transform the clinical approach to this disease. However, limited evidence exists in support of effective interventions to delay the onset or even halt the manifestation of RA. Given the multifactorial nature of RA development and disease progression, the latest guidelines for established RA stress the use of integrative interventions and multidisciplinary care strategies, combining pharmacologic treatment with non-pharmacological approaches. Accordingly, individuals at risk of RA could be offered an integrative, multifactorial intervention approach. Current data point toward pharmacological intervention reverting the subclinical inflammation and delay in the disease onset. In addition, targeting life style modifiable factors (smoking cessation, dental health, physical activity, and diet) may presumably improve RA prognosis in individuals at risk, mainly by changes in epigenetics, autoantibodies, cytokines profiles, and microbiome. Nonetheless, the benefits of multidisciplinary interventions to halt the manifestation of RA in at-risk individuals remain unknown. As there is a growing knowledge of possible pharmacological intervention in the preclinical phase, this narrative review aims to provide a comprehensive overview of non-pharmacological treatments in individuals at risk of RA. Considering the mechanisms preceding the clinical manifestation of RA we explored all aspects that would be worth modifying and that would represent an integrative non-pharmacological care for individuals at risk of RA.
- MeSH
- autoprotilátky MeSH
- lidé MeSH
- prognóza MeSH
- revmatoidní artritida * terapie farmakoterapie MeSH
- zánět MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
The aim of this study was to determine the relationship between physical fitness, cardiopulmonary function and patient-reported severity of symptoms in people with post-COVID-19 condition. We examined ambulatory patients (n = 72) with post-COVID-19 condition who had a chronic symptomatic phase lasting > 12 weeks from the onset of symptoms, but had not been hospitalized for acute COVID-19. A comprehensive medical screening was conducted, including clinical history, symptomatology, comorbidities, body composition and physical activity levels. We then identified the relationship between physical fitness (cardiorespiratory fitness and muscular strength), cardiopulmonary function (echocardiographic and spirometry parameters) and patient-reported severity of symptoms (fatigue, dyspnea, health-related quality of life, anxiety, and depression). Age, body mass index, sex, number of comorbidities and duration of symptoms were included as potential confounders. Results showed that greater physical fitness and cardiopulmonary function were associated with lower severity of symptoms in people with post-COVID-19 condition. Cardiorespiratory fitness, lower-limb muscle strength, maximal voluntary ventilation and left ventricular ejection fraction account for reducing fatigue and dyspnea. Greater physical activity levels were associated with fewer symptoms and less-severe fatigue and dyspnea. In conclusion, preserving better cardiopulmonary health and physical condition during the course of the disease-even in mild cases-was related to a lower intensity of symptoms in non-hospitalized people with post-COVID-19 condition. It is probable that exercise and physical conditioning are valuable pre- and post-COVID-19 countermeasures that could help decrease the severity, not only of acute infection, but of post-COVID-19 persistent symptoms and prognosis.
- MeSH
- biomechanika MeSH
- hypertrofie MeSH
- lidé MeSH
- rozsah kloubních pohybů fyziologie MeSH
- svaly * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
- Geografické názvy
- Řím MeSH
INTRODUCTION: There is not a doubt that tailored exercise is an effective non-pharmacological approach for preventing, mitigating and even reversing ageing-related alterations. However, older adults are likely to experience prolonged periods of inactivity and training cessation periods as a consequence of falls or hospitalisation. Although recent evidence supports that exercise could have a protective effect and help in recovering, there is to date a lack of consensus about what kind of physical exercise prescription and training duration would produce better outcomes after training cessation periods. The current study will determine the effects that available exercise prescriptions produced in older adults in preserving physical conditioning following inactivity periods. METHODS AND ANALYSIS: A systematic search of the literature will be conducted in three databases, namely PubMed, Scopus and Web of Science, from inception to 1 February 2021. Only randomised controlled trials written in English or Spanish will be eligible. No year of publication restriction will be applied. Eligible studies will contain information on population (older adults over 60 years old), intervention (inactivity period, exercise programme their duration), comparator (treatment as usual or waiting list) and outcomes (strength, functional capacity, metabolic health and skeletal muscle structure). Two independent reviewers will (1) search, screen and select studies, (2) extract data about their main characteristics and (3) evaluate their methodological and reporting quality. When disagreements emerge, the reviewers will discuss to reach a consensus. We plan to conduct meta-analysis to quantitatively synthesise the effects under study. ETHICS AND DISSEMINATION: As systematic reviews use publicly available data, no formal ethical review and approval are needed. Findings will be published in a peer-reviewed journal(s) and presented at conferences. PROSPERO REGISTRATION NUMBER: CRD42021235092.
- MeSH
- cvičení * MeSH
- lidé středního věku MeSH
- lidé MeSH
- metaanalýza jako téma MeSH
- senioři MeSH
- systematický přehled jako téma MeSH
- terapie cvičením * MeSH
- úrazy pádem MeSH
- výzkumný projekt MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
