Explore the vast range of titles available.

Sleep apnea (SA) is common in Down syndrome (DS), but its impact on daytime autonomic control is poorly described. The aim of this study was to assess the impact of SA on autonomic control of heart rate (HR) and blood pressure (BP) during a Head-Up Tilt test (HUTT) in adults with DS. Ancillary cross-sectional analysis of an observational study conducted on 28 adults with DS (31.7 ± 7.4 years; 32% female) free from congenital cardiopathy, thyroid disorders, or medication that impact autonomic control were included. Full-night polysomnography and HUTT were performed. Temporal and spectral analyses were performed on the signals of RR intervals, systolic and diastolic blood pressures (SBP and DBP). SBP and DBP min-max variations were specifically analyzed during the initial 3 min post-tilting (3minUp). 21 (75%) subjects presented moderate-severe SA (Apnea-Hypopnea Index ≥ 15/h). During the 3minUp, moderate-severe SA group showed reduced min-max variations in systolic and diastolic blood pressures (40.0 ± 10.2 vs. 51.7 ± 18.7 mmHg and 27.0 ± 7.2 vs. 39.9 ± 17.4 mmHg, all p  < 0.05) with blunted vascular sympathetic activity during the entire orthostatic phase (LF SBP ; 24.3 ± 11.7 vs. 28.6 ± 9.8 nu; p  < 0.05). SA-related intermittent hypoxia, rather than sleep fragmentation was associated with changes in SBP during the 3minUp. The baroreflex sensitivity and heart rate variability parameters were similar in both groups. SA was associated with a blunted autonomic control of BP during HUTT, without changes in HR variability parameters. SA-related intermittent hypoxia, rather than sleep fragmentation seems to play a key role in these alterations.

Physical activity (PA) programs have been found to result in improved sleep in males with autism spectrum disorder (ASD), but little is known about the female characteristics. The aim of this work was to assess sex differences in sleep and PA indices using an accelerometer over 7 days and 7 nights. Sleep and PA variables were measured with questionnaires and with accelerometry in twenty-four children with ASD (16 boys, 10.3 ± 2.8; 8 girls, 11.1 ± 3.9). Some significant differences were reported between girls and boys. The total time in bed and wake time after sleep onset (WASO) were significantly higher in girls compared to boys (p < 0.01), whereas sleep efficiency was significantly lower in girls (p < 0.01). The results obtained from the sleep questionnaire (CSHQ) show averages above the threshold of 41 in both groups (the threshold indicates the presence of sleep disorders or low sleep quality). The number of daily steps was significantly lower in the girls’ group (p < 0.01), and the PA volume for vigorous and strong vigorous intensities was significantly higher in the boys’ group (p < 0.01 and p < 0.05, respectively). Our results show major alterations in girls, with a low level of PA and sleep alteration. PA is a relevant non-pharmacological approach to improve sleep quality and achieve sufficient sleep duration. However, particularly for girls with ASD, more personalized approaches to improve sleep may be needed to manage specific associated disorders.

IntroductionDespite their exponential use, intra-articular (IA) injections of platelet-rich plasma (PRP) are not part of the recommended treatments for knee osteoarthritis (OA) by most international scientific societies. The most recent clinical trials have shown conflicting results, and some did not find any clinical benefit of PRP injections. The PRP In Knee OsteoArthritis (PIKOA) trial was designed to assess the clinical efficacy and structural benefit of IA injections of PRP vs saline solution (placebo) in symptomatic knee OA.Methods and analysisPIKOA is an academic phase 3, superiority, triple-blind (patients, investigators and injectors), multicentre, randomised placebo-controlled trial (1:1 ratio). It compares the efficacy of 1 weekly IA injection of 5 mL PRP or placebo (saline solution) for 3 weeks with a 6-month follow-up. The trial will enrol 210 participants ≥40 years old with symptomatic and moderate radiographic knee OA (Kellgren and Lawrence grade 2 or 3). PRP is prepared with the A-CP-Kit-T (20 mL) kit and its cellular composition is characterised for each patient. The main objective is to compare change in pain on a 0 mm to 100 mm visual analogue scale (VAS) between W0 and W14. The secondary objectives are to compare the two groups in terms of decrease in VAS pain, Western Ontario and McMaster Universities Osteoarthritis Index total score and subscores, analgesics consumption, OMERACT-Osteoarthritis Research Society International responder rate and improvement in quality of life measured by the EQ-5D-5L score. All these criteria are assessed at W8, W14 and W26. The decrease in serum Coll2-1 and Coll2-1 NO₂ levels (catabolic markers, reflecting cartilage destruction or joint inflammation) and increase in N-propeptide of cartilage IIA level (reflecting cartilage formation) are assessed at W8 and W14. Adverse events and study withdrawals are collected during the study.Ethics and disseminationEthics approval was obtained from the Nord Ouest ethical committee (2021-A00742-39). All participants need to provide written informed consent. The findings will be published in peer-reviewed journals.Trial registration numberNCT05378815 (ClinicalTrials.gov); pre-results.Protocol version and number: V.3 of 17 July 2023.

Vascular aging involves reduced endothelial function, a key factor in cardiovascular diseases. Intermittent hypoxia may improve endothelial function and cardiorespiratory fitness (CRF), but its effects in elderly individuals, especially in the mid‐term, have not yet been studied. This randomized, single‐blind controlled trial aimed to investigate whether an 8‐week intermittent hypoxic conditioning (IHC) program may enhance flow‐mediated dilation (FMD) and CRF in elderly individuals. Twenty‐six participants (60–80 year‐old) were assigned to either the IHC (n = 12) or the control group (CTL: n = 14). The IHC group underwent 24 passive intermittent hypoxia sessions (3/week). Brachial artery FMD, cardiopulmonary exercise testing (CPET), and ambulatory 24‐h blood pressure were assessed at baseline (Pre), immediately post‐intervention (Post 1), and 2 months later (Post 2). FMD showed a trend toward improvement in the IHC group, being significant when normalized for baseline artery diameter (p = 0.023; ηp2 = 0.150) between Pre and Post 2. Peak ventilation during CPET increased from Pre to Post 1 (p = 0.021), with no other significant CRF changes. Daytime systolic blood pressure decreased by 6 mmHg (p = 0.070, ηp2 = 0.105). No significant alterations in these outcomes were observed in the CTL group (p > 0.05). Moderate IHC enhanced mid‐term endothelial function, suggesting potential to mitigate age‐related vascular decline.

Background. Sleep problems have been reported in children with autism spectrum disorder (ASD). One of the methods proposed to improve sleep characteristics is based on physical activity (PA). Objective. To assess characteristics of sleep and the effect of PA level on sleep quality in children with ASD compared to controls. Methods. Fifty boys with ASD (ASD; 10.8 ± 2.6 years) and 18 controls (CONT, 10.1 ± 2.2 years) wore an accelerometer device for five consecutive days to obtain measures of activity and sleep characteristics. Results. Some significant differences were reported between ASD and CONT groups. Wake-up time resistance was significantly higher (p < 0.05) in ASD. Total time for PA, and daily steps number were significantly lower in the ASD group (p < 0.05). Time for sedentary behavior was significantly higher (p < 0.01) in the ASD group. Using a principal component analysis and an agglomerative hierarchical analysis, we observed three clusters. Two showed the same poor-quality indices of sleep but two opposing profiles of PA, either an insufficient PA volume (cluster 1, Total time PA = 75.1 min; Daily steps: 7704) or an important PA volume (cluster 3, Total time PA = 222.1 min; Daily steps: 17,164). Cluster 2 was characterized by moderate participation in PA and children with the best sleep indices (Total time PA = 166.8 min; Daily steps: 12,718). Conclusion. The dose–response effect of exercise on sleep may indicate large individual differences but the present findings are important to prevent sedentary behaviors or to correct over-activity that could be detrimental to the sleep quality in children with ASD.

Background: Sleep disordered breathing (SDB) is a frequent disorder with serious adverse health consequences in people with Down syndrome (DS). This study aims to evaluate and classify sleep and physical activity (PA) characteristics in adults with DS. Methods: Forty participants with DS wore an accelerometer for seven consecutive days to measure physical activity and sleep–wake patterns. The corresponding data were also obtained by survey and polysomnography. The apnea-hypopnea index (AHI) is calculated from the number of apneas and hypopneas per hour of sleep according to international guidelines. Results: Polysomnography showed SDB based on AHI in 95% of adults: 50% had severe SDB, 22.5% presented moderate and 22.5% mild SDB, predominantly in males. They had poor sleep quality (80.1%) and low PA levels. Using statistical classification methods, we observed three clusters with two opposite profiles. Clusters 2 and 3 showed low PA indices (daily steps: 5719 and 5310, respectively) and severe SDB (AHI = 33.6 and 55.5 events/h), high age and high gonial angle. Cluster 1 showed high PA (mean count of daily steps: 6908) and mild to moderate SDB (AHI = 16.8 events/h), low age and low gonial angle. Conclusions: Our findings suggest that there are different profiles (age, gender, obesity, gonial angle) that are associated with SDB in adults with DS. These results suggest that this may represent important factors to consider when planning health promotion and prevention.

Exercise limitation is a cardinal feature of fibrotic interstitial lung disease arising from pulmonary gas exchange, respiratory mechanical and cardio‐circulatory abnormalities. More recently, it has been recognized that impairment in locomotor muscle function (e.g., reduced muscle mass/strength or heightened fatigability) might also play a relevant contributory role. Exercise training as part of pulmonary rehabilitation is the most effective intervention to improve exercise tolerance, dyspnoea and quality of life in patients with fibrotic interstitial lung disease. Given that exercise training has modest effects on exertional ventilation, breathing pattern and respiratory muscle performance, improvement in locomotor muscle function is a key target for pulmonary rehabilitation in these patients. In the present narrative review, we initially discuss whether the locomotor muscles of patients might be exposed to negative risk factors. After offering corroboratory evidence on this matter (e.g., oxidative stress, inflammation, hypoxia, physical inactivity and medications), we outline their effects on skeletal muscle mass and functional properties. We finish by addressing the potentially beneficial effects of rehabilitative exercise training on these muscle‐centred outcomes, providing perspectives to facilitate or optimize the muscle benefits derived from this intervention. This narrative review, therefore, provides an up‐to‐date outline of the rationale for rehabilitative approaches focusing on the locomotor muscles in this patient population. What is the topic of this review? This review focuses on risk factors for, recent evidence for, and relevance of locomotor muscle dysfunction in fibrotic interstitial lung disease. It also focuses on the ability of rehabilitative exercise training to counteract these pre‐specified abnormalities. What advances does it highlight? We highlight that fibrotic interstitial lung disease is characterized by multiple factors known to promote muscle dysfunction. We then discuss new evidence in favour of locomotor muscle dysfunction and its role in exercise limitation. Finally, we show that the exercise training offered to date minimal, inconsistent gains in muscle strength, emphasizing the need for alternative strategies to facilitate this intervention and combat existing impairments.

Background—Adults with Down’s syndrome (DS) present lower physical fitness associated with heightened sedentary behaviors and motor skills impairments. Their etiologies and determinants seem to be heterogeneous. This study aims to evaluate physical fitness in adults with DS and to identify specific physical fitness profiles depending on gender and physical activity levels. Methods—Forty adults with DS (16 women, 24 men, 29.7 ± 7.5 years) performed six tests from the EUROFIT Battery and Motor Assessment Battery for Children (MAB-C). Their maximal aerobic capacity was assessed using an incremental treadmill test to assess (VO2peak). Ecological, physical activity, and sedentary levels were evaluated subjectively (Global Physical Activity Questionnaire) and objectively using an Actigraph GT9X® accelerometer over a seven-day period. Results—VO2peak and isometric strength were significantly lower for women (p < 0.01), whereas men had significantly lower flexibility than women (p < 0.05). Using a principal component analysis and an agglomerative hierarchical analysis, we identified three clusters. Cluster 1 (n = 14; 50% men; Body Mass index = 28.3 ± 4.3) was characterized by significantly poorer physical fitness variables (VO2peak (p < 0.01), strength (p < 0.01) and balance (p < 0.05)) compared to Clusters 2 and 3. Cluster 2 (n = 19; 58% men; Body Mass index = 22.9 ± 2.0) and Cluster 3 (n = 19; 58% men; BMI = 22.9 ± 1.9) were characterized by subjects with comparable physical fitness profiles, except for the balance capacities, which were significantly lower in Cluster 3 (p < 0.05). Conclusions—DS subjects exhibited high heterogeneity in terms of physical fitness, PA, and sedentary levels, with a significant gender effect. The present findings are important to identify subjects at higher risk of sedentary behaviors and impaired motor capacities to develop personalized PA programs.

The difficulties with motor skills in children with autism spectrum disorders (ASD) has become a major focus of interest. Our objectives were to provide an overall profile of motor capacities in children with ASD compared to neurotypically developed children through specific tests, and to identify which motor tests best discriminate children with or without ASD. Twenty-two male children with ASD (ASD—10.7 ± 1.3 years) and twenty controls (CONT—10.0 ± 1.6 years) completed an evaluation with 42 motor tests from European Physical Fitness Test Battery (EUROFIT), the Physical and Neurological Exam for Subtle Signs (PANESS) and the Movement Assessment Battery for Children ( M-ABC). However, it was challenging to design a single global classifier to integrate all these features for effective classification due to the issue of small sample size. To this end, we proposed a hierarchical ensemble classification method to combine multilevel classifiers by gradually integrating a large number of features from different motor assessments. In the ASD group, flexibility, explosive power and strength scores (p < 0.01) were significantly lower compared to the control group. Our results also showed significant difficulties in children with ASD for dexterity and ball skills (p < 0.001). The principal component analysis and agglomerative hierarchical cluster analysis allowed for the classification of children based on motor tests, correctly distinguishing clusters between children with and without motor impairments.

The aim of this study was to determine whether the power output associated with a maximal lactate steady state (MLSS) (.W(MLSS)) can be assessed using a single incremental cycling test. Eleven recreational sportsmen (age: 22+/-1 years, height: 175+/-6 cm, weight: 71+/-5 kg) volunteered to participate in the study. For each subject the first and second ventilatory thresholds (VT(1) and VT(2), respectively) and the power output corresponding to (respiratory exchange ratio) RER=1.00 were determined during an incremental test to exhaustion. Thereafter, each subject performed several 30-min constant load tests to determine MLSS. The workload used in the first constant test was set to the .W(RER=1.00) determined during the incremental test. .W(VT1) (175+/-24 W) and .W(VT2) (265+/-31 W) were significantly different from .W(MLSS )(220+/-36 W). Whereas, .W(RER=1.00) (224+/-33 W) was similar to .W(MLSS). HR, RER and .VE were significantly different between the 10th and the 30th minutes when exercising at .W(RER=1.00) and at .W(MLSS). In contrast, .VO(2) and .VCO(2) were stable over those 30-min constant tests. Power output at VT(1), RER=1.00 and VT(2) were all correlated to .W(MLSS) but the relationship was stronger between RER=1.00 and MLSS (R (2)=0.95). The present study shows that the power output associated with a RER value equal to 1.00 during an incremental test does not differ from that determined for MLSS. Hence, the MLSS can be estimated with a single exercise test.