Matching Items (24)
Description
Background: Heart failure is the leading cause of hospitalization in older adults and has the highest 30-day readmission rate of all diagnoses. An estimated 30 to 60 percent of older adults lose some degree of physical function in the course of an acute hospital stay. Few studies have addressed the role of posture and mobility in contributing to, or improving, physical function in older hospitalized adults. No study to date that we are aware of has addressed this in the older heart failure population.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
ContributorsFloegel, Theresa A (Author) / Buman, Matthew P (Thesis advisor) / Hooker, Steven (Committee member) / Dickinson, Jared (Committee member) / DerAnanian, Cheryl (Committee member) / McCarthy, Marianne (Committee member) / Arizona State University (Publisher)
Created2015
Description
Many individual-level behavioral interventions improve health and well-being. However, most interventions exhibit considerable heterogeneity in response. Put differently, what might be effective on average might not be effective for specific individuals. From an individual’s perspective, many healthy behaviors exist that seem to have a positive impact. However, few existing tools support people in identifying interventions that work for them, personally.
One approach to support such personalization is via self-experimentation using single-case designs. ‘Hack Your Health’ is a tool that guides individuals through an 18-day self-experiment to test if an intervention they choose (e.g., meditation, gratitude journaling) improves their own psychological well-being (e.g., stress, happiness), whether it fits in their routine, and whether they enjoy it.
The purpose of this work was to conduct a formative evaluation of Hack Your Health to examine user burden, adherence, and to evaluate its usefulness in supporting decision-making about a health intervention. A mixed-methods approach was used, and two versions of the tool were tested via two waves of participants (Wave 1, N=20; Wave 2, N=8). Participants completed their self-experiments and provided feedback via follow-up surveys (n=26) and interviews (n=20).
Findings indicated that the tool had high usability and low burden overall. Average survey completion rate was 91%, and compliance to protocol was 72%. Overall, participants found the experience useful to test if their chosen intervention helped them. However, there were discrepancies between participants’ intuition about intervention effect and results from analyses. Participants often relied on intuition/lived experience over results for decision-making. This suggested that the usefulness of Hack Your Health in its current form might be through the structure, accountability, and means for self-reflection it provided rather than the specific experimental design/results. Additionally, situations where performing interventions within a rigorous/restrictive experimental set-up may not be appropriate (e.g., when goal is to assess intervention enjoyment) were uncovered. Plausible design implications include: longer experimental and phase durations, accounting for non-compliance, missingness, and proximal/acute effects, and exploring strategies to complement quantitative data with participants’ lived experiences with interventions to effectively support decision-making. Future work should explore ways to balance scientific rigor with participants’ needs for such decision-making.
One approach to support such personalization is via self-experimentation using single-case designs. ‘Hack Your Health’ is a tool that guides individuals through an 18-day self-experiment to test if an intervention they choose (e.g., meditation, gratitude journaling) improves their own psychological well-being (e.g., stress, happiness), whether it fits in their routine, and whether they enjoy it.
The purpose of this work was to conduct a formative evaluation of Hack Your Health to examine user burden, adherence, and to evaluate its usefulness in supporting decision-making about a health intervention. A mixed-methods approach was used, and two versions of the tool were tested via two waves of participants (Wave 1, N=20; Wave 2, N=8). Participants completed their self-experiments and provided feedback via follow-up surveys (n=26) and interviews (n=20).
Findings indicated that the tool had high usability and low burden overall. Average survey completion rate was 91%, and compliance to protocol was 72%. Overall, participants found the experience useful to test if their chosen intervention helped them. However, there were discrepancies between participants’ intuition about intervention effect and results from analyses. Participants often relied on intuition/lived experience over results for decision-making. This suggested that the usefulness of Hack Your Health in its current form might be through the structure, accountability, and means for self-reflection it provided rather than the specific experimental design/results. Additionally, situations where performing interventions within a rigorous/restrictive experimental set-up may not be appropriate (e.g., when goal is to assess intervention enjoyment) were uncovered. Plausible design implications include: longer experimental and phase durations, accounting for non-compliance, missingness, and proximal/acute effects, and exploring strategies to complement quantitative data with participants’ lived experiences with interventions to effectively support decision-making. Future work should explore ways to balance scientific rigor with participants’ needs for such decision-making.
ContributorsPhatak, Sayali Shekhar (Author) / Buman, Matthew P (Thesis advisor) / Hekler, Eric B. (Committee member) / Huberty, Jennifer L (Committee member) / Johnston, Erik W., 1977- (Committee member) / Swan, Pamela D (Committee member) / Arizona State University (Publisher)
Created2019
Description
The purpose of this study was to examine the feasibility and preliminary efficacy of a theory-driven and a atheoretical reminder point-of-choice (PoC) prompt interventions on reducing workplace sedentary behavior in office workers with self-reported low usage (<4 hours per day) of their sit-stand workstations in the standing position. The design of this study was a cross-over trial including randomization into either the theory-driven or atheoertical reminder condition, after completion of a no prompt control condition. Participants (N=19) included full-time, primarily female, Caucasian, middle-aged office workers. The primary aim of this study was to assess the feasibility of these two PoC prompt conditions on reducing sedentary behaviors through the use of a Therapy Evaluation Questionnaire. The secondary aim of this study was to assess the preliminary efficacy of the two PoC prompt conditions on reducing sedentary behaviors relative to no-prompt control using the activPAL micro device. For the primary aim, descriptive means adjusted for ordering effect were computed. For the secondary aim, mixed-effects regression models were used to cluster for observations within-persons and were adjusted for age, gender, race, job-type, and ordering effects. During the no-prompt control, participants spent 267.90 ± 68.01 sitting and 170.20 ± 69.34 min/8hr workday standing. The reminder PoC prompt condition significantly increased sanding time (b[se] = 24.52 [11.09], p=0.034) while the theory-driven PoC condition significantly decreased time spent in long sitting bouts b[se] = -34.86 [16.20], p=0.036), both relative to no prompt control. No statistically significant reductions in sitting time were seen in either PoC prompt condition. Furthermore, no statistically significant differences between the two PoC prompt conditions were observed. This study provides feasibility insight in addition to objective measures of sedentary behaviors regarding the use of PoC prompt interventions in the workplace.
ContributorsLarouche, Miranda (Author) / Buman, Matthew P (Thesis advisor) / Ainsworth, Barbara E (Thesis advisor) / Huberty, Jennifer L (Committee member) / Arizona State University (Publisher)
Created2018
Description
The purpose of this dissertation was 1) to develop noninvasive strategies to assess skeletal muscle size, architecture, and composition in young and old adults (study #1) and 2) evaluate the impact of chemotherapeutic treatment on skeletal muscle satellite cells and capillaries (study #2). For study #1 ultrasound images were obtained from the quadriceps muscles of young (8 m, 8 f) and older (7 m, 5 f) participants on two occasions, separated by 5-15 days. Images were collected while the participants were both standing and supine, and were analyzed for muscle thickness, pennation angle, and echogenicity. In addition, test-retest reliability and ICCs were evaluated for each posture and when imaging sites remained marked or were re-measured from visit #1 to visit #2. Generally, in both younger and older adults muscle thickness was greater and echogenicity was lower in the anterior quadriceps when images were collected standing versus supine. Maintaining the imaging site between visits did not influence test re-test reliability for either age group. Older adults exhibited smaller muscle thickness, lower pennation angle and increased echogenicity. Further, variability for the use of ultrasound to determine muscle thickness and pennation angle was greater in older versus younger adults. Findings from study #1 highlight several methodological considerations for US-based assessment of skeletal muscle characteristics that should be considered for improving reproducibility and generalizability of US to assess skeletal muscle characteristics and function across the aging spectrum. This is particularly relevant given the emerging use of ultrasound to assess skeletal muscle characteristics in healthy and clinical populations. In the second study, ovariectomized female Sprague-Dawley rats were randomized to receive three bi-weekly intraperitoneal injections of the chemotherapeutic drug, Doxorubicin (DOX) (4mg/kg; cumulative dose 12mg/kg) or vehicle (VEH; saline). Animals were euthanized 5d following the last injection, and the soleus (SOL) and extensor digitorum longus (EDL) muscles were dissected and prepared for immunohistochemical and RT-qPCR analyses. Relative to VEH, cross-sectional area (CSA) of the SOL and EDL muscle fibers were 26% and 33% smaller, respectively, in DOX animals (P<0.05). In the SOL satellite cell and capillary densities were 39% and 35% lower, respectively, in DOX animals (P<0.05), whereas in the EDL satellite cell and capillary densities were unaffected by DOX administration (P>0.05). In the SOL MYF5 mRNA expression was increased in DOX animals (P<0.05), while in the EDL MGF mRNA expression was reduced in DOX animals (P<0.05). Chronic DOX administration is associated with reduced fiber size in multiple skeletal muscles, however DOX appears to impact the satellite cell and capillary densities in a muscle-specific manner. These findings from study #2 highlight that therapeutic targets to protect skeletal muscle from DOX may vary across muscles. Collectively, these findings 1) improve the ability to examine muscle size and function in younger and older adults, and 2) identify promising therapeutic targets to protect skeletal muscle from the harmful effects of chemotherapy treatment.
ContributorsD'Lugos, Andrew (Author) / Dickinson, Jared M (Thesis advisor) / Buman, Matthew P (Committee member) / Gaesser, Glenn A (Committee member) / Huentelman, Matthew J (Committee member) / Katsanos, Christos S (Committee member) / Arizona State University (Publisher)
Created2018
Description
Obesity impairs skeletal muscle maintenance and regeneration, a condition that can progressively lead to muscle loss, but the mechanisms behind it are unknown. Muscle is primarily composed of multinucleated cells called myotubes which are derived by the fusion of mononucleated myocytes. A key mediator in this process is the cellular fusion protein syncytin-1. This led to the hypothesis that syncytin-1 could be decreased in the muscle of obese/insulin resistant individuals. In contrast, it was found that obese/insulin resistant subjects had higher syncytin-1 expression in the muscle compared to that of the lean subjects. Across the subjects, syncytin-1 correlated significantly with body mass index, percent body fat, blood glucose and HbA1c levels, insulin sensitivity and muscle protein fractional synthesis rate. The concentrations of specific plasma fatty acids, such as the saturated fatty acid (palmitate) and monounsaturated fatty acid (oleate) are known to be altered in obese/insulin resistant humans, and also to influence the protein synthesis in muscle. Therefore, it was evaluated that the effects of palmitate and oleate on syncytin-1 expression, as well as 4E-BP1 phosphorylation, a key mechanism regulating muscle protein synthesis in insulin stimulated C2C12 myotubes. The results showed that treatment with 20 nM insulin, 300 µM oleate, 300 µM oleate +20 nM insulin and 300 µM palmitate + 300 µM oleate elevated 4E-BP1 phosphorylation. At the same time, 20 nM insulin, 300 µM palmitate, 300 µM oleate + 20 nM insulin and 300 µM palmitate + 300 µM oleate elevated syncytin-1 expression. Insulin stimulated muscle syncytin-1 expression and 4E-BP1 phosphorylation, and this effect was comparable to that observed in the presence of oleate alone. However, the presence of palmitate + oleate diminished the stimulatory effect of insulin on muscle syncytin-1 expression and 4E-BP1 phosphorylation. These findings indicate oleate but not palmitate increased total 4E-BP1 phosphorylation regardless of insulin and the presence of palmitate in insulin mediated C2C12 cells. The presence of palmitate inhibited the upregulation of total 4EB-P1 phosphorylation. Palmitate but not oleate increased syncytin-1 expression in insulin mediated C2C12 myotubes. It is possible that chronic hyperinsulinemia in obesity and/or elevated levels of fatty acids such as palmitate in plasma could have contributed to syncytin-1 overexpression and decreased muscle protein fractional synthesis rate in obese/insulin resistant human muscle.
ContributorsRavichandran, Jayachandran (Author) / Katsanos, Christos (Thesis advisor) / Coletta, Dawn (Committee member) / Dickinson, Jared (Committee member) / Arizona State University (Publisher)
Created2017
Description
ABSTRACT
Background: Although aerobic exercise has been shown to improve the glycemic control of individuals with type 2 diabetes, a simple and effective approach to manage post-meal glycemic control remains less clear.
Purpose: This study examined the effect of 15-minute of post-meal aerobic exercise on the glycemic control and anxiety scores as compared with control trials in participants with and without type 2 diabetes.
Methods: Six adults volunteered to participate in the study (3 adults with type 2 diabetes, age = 44.33 ± 7.71; and 3 adults without type 2 diabetes, age = 31.67 ± 15.76). All participants received aerobic exercise intervention and control treatments. The aerobic exercise treatment was listening to upbeat music and dancing for 15-minutes, whereas the control participants ingested 1 gram of vitamin C 30-minutes post-meal. Glucose levels were measured at baseline, and the 10, and 15-minute mark in both exercise intervention and control conditions 30-minutes post-meal.
Results: There was a significant interaction between treatment and time on the change in glucose levels (P<0.001). There was a significant mean difference in change in glucose levels between exercise intervention and control conditions (P = 0.002). Change in glucose levels in exercise intervention was significantly decreased at 10-minute (-18 ± 4.35 vs. 1.67 ± 4.34, P = 0.009) and 15-minute (-24 ± 4.88 vs. 5.67 ± 4.88, P = 0.001) compared with control condition. Although there were no statistical differences in state anxiety scores between pre- and post-exercise intervention (p=0.42), there was a significant trend in the reduction of state anxiety scores in diabetic participants, as compared with healthy participants, after 15-minute exercise intervention (-8 vs. -1).
Conclusion: Aerobic exercise for 15-minute by dancing to music after a meal is an effective approach to controlling the blood glucose levels in type 2 diabetic and healthy persons.
Background: Although aerobic exercise has been shown to improve the glycemic control of individuals with type 2 diabetes, a simple and effective approach to manage post-meal glycemic control remains less clear.
Purpose: This study examined the effect of 15-minute of post-meal aerobic exercise on the glycemic control and anxiety scores as compared with control trials in participants with and without type 2 diabetes.
Methods: Six adults volunteered to participate in the study (3 adults with type 2 diabetes, age = 44.33 ± 7.71; and 3 adults without type 2 diabetes, age = 31.67 ± 15.76). All participants received aerobic exercise intervention and control treatments. The aerobic exercise treatment was listening to upbeat music and dancing for 15-minutes, whereas the control participants ingested 1 gram of vitamin C 30-minutes post-meal. Glucose levels were measured at baseline, and the 10, and 15-minute mark in both exercise intervention and control conditions 30-minutes post-meal.
Results: There was a significant interaction between treatment and time on the change in glucose levels (P<0.001). There was a significant mean difference in change in glucose levels between exercise intervention and control conditions (P = 0.002). Change in glucose levels in exercise intervention was significantly decreased at 10-minute (-18 ± 4.35 vs. 1.67 ± 4.34, P = 0.009) and 15-minute (-24 ± 4.88 vs. 5.67 ± 4.88, P = 0.001) compared with control condition. Although there were no statistical differences in state anxiety scores between pre- and post-exercise intervention (p=0.42), there was a significant trend in the reduction of state anxiety scores in diabetic participants, as compared with healthy participants, after 15-minute exercise intervention (-8 vs. -1).
Conclusion: Aerobic exercise for 15-minute by dancing to music after a meal is an effective approach to controlling the blood glucose levels in type 2 diabetic and healthy persons.
ContributorsSymons, Nicholas Payne (Author) / Lee, Chong (Thesis director) / Dickinson, Jared (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / W. P. Carey School of Business (Contributor)
Created2015-05
Description
Doxorubicin (DOX) is a cardiotoxic, anthracycline-based, anti-neoplastic agent that causes pathological cardiac remodeling due to altered protein expression associated with cardiotoxicity. DOX cardiotoxicity causes increased Akt phosphorylation, blunted AMPK phosphorylation and upregulated mTOR phosphorylation. Akt is activated by cellular stress and damage. AMPK is activated by increases in AMP and ADP concentrations and decreased ATP concentration. mTOR is active in cellular growth and remodeling. These proteins are cellular kinases with cascades that are influenced by one another. Exercise preconditioning may diminish the cardiotoxic effects on these proteins. Female, Ovariectomized Sprague-Dawley rats (N=33) were randomized to: Exercise+DOX (EX+DOX, n=9); Exercise+Vehicle (EX+VEH, n=8); Sedentary+DOX (SED+DOX, n=8); and Sedentary+Vehicle (SED+VEH, n=8) groups. DOX (4mg/kg) or VEH (saline) intraperitoneal injections were administered bi-weekly (cumulative dose of 12mg/kg). VEH animals received body weight matched volumes of saline based on dosing in animals receiving DOX. Exercise (EX) animals underwent high intensity (85-95% VO2 peak) interval training (HIIT) (4x4 min bouts) separated by low intensity (50-60% VO2max) intervals (2 min bouts) 5 days per week. Exercise began 1 week prior to the first injection and was continued throughout the study. Rats were euthanized 5 days after the last injection. Left ventricular tissue was isolated, processed into lysate and used for western blot analyses [2x2 ANOVA; (α=0.05)]. DOX induced significant phosphorylation of Akt and mTOR (p=0.035; p=0.032) only in SED+DOX rats, but unchanged in EX+DOX rats. No significant differences (p=0.374) in AMPK phosphorylation were observed between groups. Exercise Preconditioning prevents some DOX-induced changes in the cardiac mTOR signaling pathway implicated in pathological remodeling.
ContributorsPanknin, Timothy M (Author) / Angadi, Siddhartha (Thesis director) / Sweazea, Karen (Committee member) / Dickinson, Jared (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
This study was designed with the goal of measuring the effects of sleep deprivation on muscle function. Participants in this study consisted of 19 individuals, 11 of which were in the restricted group (age 251) and 8 were in the control group (age 231). Measurements of muscle function included isometric strength, isokinetic velocity, and muscle soreness. Isometric strength and isokinetic velocity were taken for knee extension using a dynamometer. Muscle soreness was measured via a 100mm likert visual analogue scale for the step-up and step-down movements with the effected leg. Measurements were taken at baseline, and 48 hours after the damaging bout of eccentric exercise following either 8 hours of sleep per night or 3 hours of sleep per night. Results show that there were no statistical differences between groups for either measurements of isometric strength, isokinetic velocity, or muscle soreness. Due to possible confounding factors, future research needs to be conducted in order to get a better understanding of the effects of sleep deprivation on muscle function.
ContributorsSalmeron-Been, Aaron James (Author) / Dickinson, Jared (Thesis director) / Youngstedt, Shawn (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
The anthracycline drug Doxorubicin (DOX) is a highly effective treatment for breast cancer, but its clinical utility is limited by dose-dependent cardiovascular toxicity. The toxic effects are partly attributed to DOX-induced generation of reactive oxygen species, which may impair nitric oxide-mediated vasodilation. Exercise training activates antioxidant defense mechanisms and is thus hypothesized to counteract oxidative stress when initiated prior to DOX administration. Adult 8-week old, ovariectomized female Sprague-Dawley rats were divided into 4 groups: sedentary + vehicle (Sed+Veh); Sed+DOX; exercise + veh (Ex+Veh); and Ex+DOX. Rats in the exercise groups were preconditioned with high intensity interval training consisting of 4x4 minute bouts of exercise at 85-95% of VO2peak separated by 2 minutes of active recovery performed 5 days per week. Exercise was implemented one week prior to the first injection and continued throughout the study. Animals received either DOX (4mg/kg) or veh (saline) intraperitoneal injections bi-weekly for a cumulative dose of 12 mg/kg per animal. Five days following the final injection, animals were anesthetized with isoflurane, decapitated and aortas and perivascular adipose tissue (PVAT) were removed for western blot analyses. No significant differences in aortic protein expression were detected for inducible nitric oxide synthase (iNOS) or the upstream activator of endothelial nitric oxide synthase (eNOS), Akt, across groups (p>0.05), whereas eNOS protein expression was significantly downregulated in Sed+DOX (p=0.003). In contrast, eNOS expression was not altered in Ex+DOX treated animals. Protein expression of iNOS in PVAT was upregulated with exercise in the DOX-treated groups (p=0.039). These findings suggest that exercise preconditioning may help mitigate vascular effects of DOX by preventing downregulation of eNOS in the aorta.
ContributorsO'Neill, Liam Martin (Author) / Sweazea, Karen (Thesis director) / Angadi, Siddhartha (Committee member) / Dickinson, Jared (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
This study aimed to identify the emotional/affective sources of discrepancies between physical activity behavior and a widely used self-perception measure of physical activity motivation. Overweight women (body mass index [BMI] ≥ 25 kg/m2, 18-64 years of age; N=37) were recruited from Arizona State University community through flyers and online newsletters. Participants wore a SenseWear accelerometer for 6 nights and 7 days and followed their normal patterns of daily living. Participants then completed a single lab visit and verbally responded to questions from the Behavorial Regulation Exercise Questionnaire (BREQ-2) while being video and audio recorded. Captured emotional responses were evaluated with facial recognition software (Noldus FaceReader). Discrepancies between BREQ-2 responses and physical activity behavior were associated with happiness and sadness emotional responses extracted from the facial recognition software using regression-based analyses. Results indicated an association between monitored physical activities and captured emotional response - specifically sadness - and that as intensity in physical activity increases, motivation increases. Associations between happiness/sadness and physical activity were not observed for all intensities of physical activity. A marginally significant association was observed for amotivation and sedentary, light-intensity physical activity, and moderate-vigorous physical activity in the sample. This study demonstrates a proof-of-concept for the integration of an empirical evaluation of happiness and sadness emotional states into the relationship between physical activity motivation and behavior.
ContributorsBryant, Sarah (Author) / Buman, Matthew P (Thesis advisor) / Chisum, Jack W (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2016