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1.
Initial observations on sexual dysfunction as a symptom of chemotherapy-induced peripheral neuropathy
Nadine Reimer, Dominik Ratiu, Damir Zubac, Helmar C. Lehmann, Freerk T. Baumann, 2023, other scientific articles

Abstract: Introduction: Peripheral neuropathy (PNP) in feet and/or hands and sexual dysfunction are common side effects of cancer therapies. In Nadine Reimer1 Dirk Brodesser1 patients with other diseases, there is evidence of an association Dominik Ratiu2 between peripheral nervous system disorders and sexual dysfunction due to the impact of impaired neuronal control on genital organ sensi- Damir Zubac1 tivity. In cancer patient interviews, it has now been observed that PNP Helmar C. Lehmann3 and sexual dysfunction may be related. The aim of the study was to Freerk T. Baumann1 investigate the potential association between PNP, sexual dysfunction, and physical activity behavior. Methods: Ninety-three patients with PNP of the feet and/or hands were interviewed in August/September 2020 in a cross-sectional study re- 1 University of Cologne, Department I of Internal garding medical history, sexual dysfunction and functionality of the genital organs. Medicine, Center for Integrated Oncology Aachen Results: Thirty-one persons who participated in the survey provided Bonn Cologne Dusseldorf, seventeen evaluable questionnaires (four men, thirteen women). Nine University Hospital of women (69%) and three men (75%) reported sensory disorders of the Cologne, Germany genital organs. Three men (75%) had erectile dysfunction. All men who 2 University of Cologne, Clinic had sensory symptoms of the genital organs received chemotherapy, and Polyclinic for Gynecology and Obstetrics, University Hospital Cologne, Germany and one man also received immunotherapy. Eight women were sexually active. Five (63%) of them reported genital organ symptoms and mainly lubrication disorders. Four (80%) of the five sexually inactive women 3 University of Cologne, Clinic reported genital organ symptoms. Eight of the nine women with sensory and Polyclinic for Neurology, University Hospital Cologne, Germany symptoms of the genital organs received chemotherapy, and one woman received immunotherapy. Discussion: Our limited data suggest genital organ sensory symptoms in chemotherapy and immunotherapy patients. Genital organ symptoms do not appear to be directly related to sexual dysfunction, and the association between PNP and genital organ symptoms appears to be more pronounced in sexually inactive women. Chemotherapy could cause sensory symptoms of the genital organs and sexual dysfunction by damaging genital organ nerve fibers. Chemotherapy and anti-hormone therapy (AHT) could trigger a disturbance of the hormone balance, which in turn could be causative for sexual dysfunction. It remains open whether the cause of these disorders is the symptomatology of the genital organs or the altered hormone balance. The significance of the results is limited due to the small number of cases. To our knowledge, this study is the first of its kind in cancer patients and allows a better understanding of the association between PNP, sensory symptoms of the genital organs, and sexual dysfunction. Conclusion: In order to be able to narrow down the cause of these initial observations in cancer patients more precisely, larger studies are needed that can relate the influence of cancer therapy-induced PNP, physical activity level and hormone balance to sensory symptoms of the genital organs and sexual dysfunction. The methodology of further studies should take into account the frequent problem of low response rates in surveys on sexuality.
Keywords: peripheral neuropathy, genital organs, sexual disfunction, oncology, exercise therapy, physical activity
Published in DiRROS: 05.11.2025; Views: 112; Downloads: 56
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2.
Feasibility and safety of impact‑loading exercise in patients with multiple myeloma—a pilot study
Anne Kollikowski, Marei Schallock, Ruben Ringeisen, Dirk Hasenclever, Lothar Seefried, Jan-Peter Grunz, Damir Zubac, Claudia  Löffler, Freerk T. Baumann, Franziska Jundt, 2025, original scientific article

Abstract: Purpose Patients with multiple myeloma (MM) develop osteolytic lesions with fractures, pain, and impaired quality of life. Preclinical data show an anabolic effect of loading exercise in osteolytic lesions of MM. This 6-month pilot study evaluated feasibility and safety of impact-loading exercise in patients with MM after assessment of spinal stability. Methods We assigned 20 patients to perform 45 min of guided impact-loading exercise twice a week and home-based training once a week or stretching exercise twice a week. Primary endpoint was assessment of feasibility and safety. Secondary endpoints were assessments of physical performance, quality of life, and bone remineralization. Results Of 77 eligible patients with MM, 26% accepted participation. In the impact group, 9/12 and in the stretching group 7/8 patients completed training with adherence rates of 65.8 and 81.1%. Ninety percent of the stamping and jumping exercises were performed with increasing intensity from the prescribed training volume of ≥ 100%. Low severity pain events were reported after 32.9% of impact sessions. No serious adverse events were observed. After 6 months, 6-minute walk distance increased in the impact group by 35 m and in the stretching group by 46 m, and chair-rise test improved in the stretching group by 1.7 s. Global health status increased by 24.9% in the impact group, and functional scale by 31.9% in the stretching group based upon EORTC QLQ-C30. No signs of bone remineralization were observed in computed tomography. Conclusion Impact training is feasible and appears to be safe in selected MM patients.
Keywords: multiple myeloma, feasibility, safety, impact-loading exercise, bone turnover maker
Published in DiRROS: 13.10.2025; Views: 136; Downloads: 58
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3.
The impact of an acrobatics-based curriculum on motor fitness in adolescents
Saša Veličković, Edvard Kolar, Miloš Paunović, Petar Veličković, Saša Bubanj, Igor Ilić, Bojan Bjelica, Tomislav Gašić, Adem Preljević, Ana-Maria Vulpe, Bogdan Constantin Rață, Cristina-Elena Stoica, Nicolae-Lucian Voinea, Tatiana Dobrescu, 2025, original scientific article

Abstract: (1) Background: This study aimed to examine whether an experimental acrobatics curriculum, conducted three times a week, could lead to greater improvements in specific components of motor fitness—coordination, balance, agility, and speed—compared to the standard physical education program; (2) Methods: The research was conducted over a 16-week period and included 50 seventh-grade students, divided into an experimental group (EG, n = 25) and a control group (CG, n = 25). The experimental group participated in a program of acrobatics and skipping twice a week, while the control group followed the standard physical education curriculum. Motor skills tests were administered before and after the intervention using standardized methods; (3) Results: Results from the ANCOVA analysis showed significant improvements in flexibility, coordination, balance, and agility in the experimental group, with large effect sizes, confirming the effectiveness of the acrobatics and skipping program. However, the impact on speed was variable, indicating the need for specific exercises to improve this ability; (4) Conclusions: The findings are consistent with previous research, highlighting the superiority of specialized acrobatic exercises in enhancing overall motor performance in adolescents. Further research is needed to optimize acrobatics and skipping programs for maximum benefits in the development of motor skills and physical education.
Keywords: physical education program, motor skill development, exercise intervention, physical activity, training adaptations, skill acquisition
Published in DiRROS: 14.05.2025; Views: 466; Downloads: 275
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4.
Evidence-based exercise recommendations to improve functional mobility in older adults - A study protocol for living systematic review and meta-analysis
Bettina Wollesen, Tamar Yellon, Antoine Langeard, Vera Belkin, Anna Wunderlich, Eleftheria Giannouli, Guoping Qian, Rafael A. Bernades, Zbigniew Ossowski, Uroš Marušič, Rajesh Sighdel, Claudia Voelcker-Rehage, 2025, original scientific article

Abstract: Background and objectives This is a protocol for a living systematic review and meta-analysis. This review will assess the effects of state-of-the-art exercise interventions designed to promote functional mobility. Therefore, after identifying all potential interventions, we will use the F.I.T.T. principles (frequency, intensity, time, type) as well as the physical and health status of the participants as moderators to analyse the mechanisms for the positive benefits of exercise interventions. The main research questions are: Which exercise types are most beneficial for improving functional mobility in various populations of older adults? Which physical exercise characteristics in terms of frequency, intensity, time and duration will achieve the greatest benefit in terms of the defined outcomes, i.e, the functional mobility of older adults? Methods The systematic literature research according to PRISMA guidelines will search databases like MEDLINE, APA Psych-Info and Web of Science. Inclusion criteria are: healthy older people ≥ 50 years, randomized-controlled trials including exercise intervention and a walking or mobility assessments (eg., TUG, SPPB) as an outcome measure. A preliminary search revealed more than 33,000 hits that will be screened by pairs of independent reviewers. The results will be summarized according to the effects regarding functional mobility and potential dose-response relations via respective meta-analysis. Conclusion The systematic review will comprise the knowledge of the existing literature with regards to the effects of the physical activity interventions compared to an active or inactive control group. We will summarize the effects with respect to the F.I.T.T.. They provide a foundation for structuring an optimal exercise training program. If possible, we will also compare interventions from the different categories (eg. cardiovascular, resistance, motor-coordinative, multicomponent or mind-body exercise) as a network analysis and report the influence of moderator variables. Based on the results evidence-based guidelines following GRADE for physical exercise interventions to improve functional mobility in older adults will be provided. Functional mobility of older adults is a crucial determinant of health and independence. Mobility can reverse or delay age-related health issues and promote independence, while immobility or limitations in mobility (such as difficulty rising from a chair, balance problems, or reduced walking capacity) can cause or increase dependency. This underscores the significance of fostering mobility among the growing population of older adults. The development of tailored exercise programs targeting the independence of older adults is one of the motivators for the improvement of crucial policy action areas described by WHO in the Equity Policy Tool, namely ʻliving conditionsʼ and ʻsocial and human capitalʼ (WHO, 2019). The key outcomes related to functional mobility in older age include gait, walking capacity, and balance. Additionally, aspects of life-space mobility, such as the overall walking distance within the environment, are significant factors that characterize mobility in older adults. Exercise can be seen as a preventive measure, so that, without adequate physical activity levels, the ageing process may be associated with premature development of disease and dysfunction. However, different training types will enhance outcomes of functional mobility via specific pathways. For example, walking capacity has an endurance and a strength component. Accordingly, aerobic training will improve walking capacity by enhancing cardio-respiratory fitness, as shown within different clinical trials with older patient cohorts. Resistance training helps to increase muscle strength in the lower limb, which increases gait stability. However, recent literature reviews showed that a combination of both interventions might be more sufficient to gain most benefits on walking capacity. This review will systematically assess the effects of state-of-the-art exercise interventions designed to promote mobility. The ultimate aim is to provide evidence-based guidelines for the optimal type and dose of exercise to preserve and enhance functional mobility in diverse populations of older adults
Keywords: functional mobility, older adults, exercise programs, systematic review
Published in DiRROS: 10.03.2025; Views: 613; Downloads: 444
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5.
Acute effects of high-intensity interval training on microvascular circulation : a case control study in uveal melanoma
Michael Mendes Wefelnberg, Johanna Hubert, Freerk T. Baumann, Damir Zubac, 2024, original scientific article

Abstract: Objectives: The aim of this study was to explore the acute effects of high-intensity interval training (HIIT) on the microvascular circulation and vascular tumor microenvironment (TME) in a patient with uveal melanoma (UM). Additionally, the acceptance of the applied diagnostics and the exercise protocol in a clinical ophthalmic-oncology setting were evaluated. Methods: This case-control study included a young adult male patient with UM previously treated with radiation and an age-matched healthy control. Participants underwent a baseline assessment of dynamic retinal vessel analysis (DRVA) and cardiopulmonary exercise testing (CPET) to determine endothelial function and intensity for HIIT. Optical coherences tomography angiography (OCTA) was performed before, immediately and 30 min after one session of HIIT. The primary outcome were changes in ocular vessel parameters and whole body oxygen uptake. Results: The UM patient exhibited lower arterial dilation and constriction in the affected eye compared to his healthy eye and both eyes of the healthy control. OCTA revealed heterogeneous patterns of vascular response to HIIT in both participants. The tumor eye showed an increase followed by a significant decrease in vessel density post-exercise, while the healthy control exhibited minor increases. Conclusions: The findings of this study highlighted the potential of UM combined with OCTA and DRVA as a model for examine exercise-induced vascular effects within the TME. However, a pre-treated UM as well as detailed image analyses and further research with longitudinal, randomized controlled designs are essential to validate these findings and address methodological limitations. Such investigations could refine integrative cancer treatment.
Keywords: uveal melanoma, endothelial dysfunction, aerobic exercise, oxygen kinetics
Published in DiRROS: 21.11.2024; Views: 632; Downloads: 766
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6.
Effect of graded exercise therapy and medical care on chronic fatigue syndrome
Tamara Zličić, Darinka Korovljev, Tijana Šćepanović, Ivana Milovanović, 2023, review article

Abstract: Purpose: Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis (ME) is a complex condition with debilitating symptoms that significantly impact individuals, particularly those in the working population. This study aims to investigate the effec-tiveness of Graded Exercise Therapy (GET) and Cognitive Behavioral Therapy (CBT) along with additional methods such as Graded Exercise Self-help (GES), Adaptive Pac-ing Therapy (APT), and Specialist Medical Care (SMC), in managing Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis (ME) among the working population. Methods: A systematic analysis of five randomized controlled trials conducted be-tween 2013 and 2023, encompassing GET, CBT, APT, SMC, and GES was performed using PubMed.Results: The selected studies consistently demonstrate that GET positively impacts physical functioning and reduces fatigue levels in working individuals with CFS. Ad-ditionally, CBT proves valuable, emphasizing the importance of addressing the mental aspects of CFS in occupational contexts.Conclusion: This review underscores the need for further research, advocating for direct assessment methods like biomarkers to enhance our understanding of CFS and improve treatment outcomes. These insights are crucial for healthcare practitioners, researchers, and policymakers navigating the complexities of CFS within the work-place. Emphasizing the integration of psychological interventions with physical therapies is essential for a comprehensive approach to managing CFS among the working population.
Keywords: Chronic Fatigue Syndrome / Myalgic Encephalomyelitis, CFS/ME, graded exercise therapy, cognitive behavioral therapy, adaptive pacing therapy, specialist medical care, working population
Published in DiRROS: 17.04.2024; Views: 1030; Downloads: 704
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7.
Development and preliminary validation of the scale of factors which influence decision-making of the elderly to take part in physical exercise programs
Tatjana Tomažič, Bojana Filej, Nadja Plazar, 2023, original scientific article

Abstract: Regular physical activity and exercise are beneficial for both physical and mental health. However, in the elderly, the level of physical activity they partake in is consist-ently inadequate. Recognizing the need to enhance the participation of the elderly in organized physical exercise and understanding the factors which influence their deci-sion-making becomes pivotal. The purpose of this study was to develop a measurement instrument, specifically a scale, to identify these factors and evaluate its psychometric properties. First, the statements were formulated, which was followed by content as-sessment by a panel of experts. In the process of scale validation, its internal consist-ency, stability, correlations between the variables, and factor structure were also evalu-ated. The scale was tested on a sample of 1777 participants engaged in guided physical exercise at the School of Health Association (društvo Šola zdravja), all aged 60 years or more. Theexploratory factor analysis yielded a four-factor model with 27 state-ments which explained 42.9% of variability. The results indicated weak, but statistically significant correlations between the factors and an acceptable level of internal consist-ency and stability of the entire scale. This scale, developed to establish the factors that influence the decision-making of the elderly to take part in organized physical exercise, represents a valid and reliable measurement instrument, which can be beneficial in the planning and promotion of organized physical exercise programs for the elderly.
Keywords: physical exercise, quantitative methodology, elderly, social gerontology
Published in DiRROS: 16.04.2024; Views: 893; Downloads: 678
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8.
Attitudes towards exercise content on social media and the choice of fitness trainer
Nikolina Alerić, Ana Penjak, Hrvoje Karninčič, 2023, original scientific article

Abstract: The aim of this study was to: a) investigate and determine gender differences to-wards factors influencing gym-goers’ choice of fitness trainer; and b) to identify and explain gender differences in gym-goers’ attitudes towards social media exercise con-tents (SMEC). For this purpose, a questionnaire was created. The study was conducted on a sample of 50 gym-goers (N1=13 male and N2=37 female), all attending a gym in Split, Croatia. The variable sample consisted of five groups of variables. Test-retest overlap was performed to determine the reliability (88.20%) of the questionnaire. The results showed that the affirmative attitudes were statistically significant in contrast to the non-affirmative attitudes (Wilcoxon Matched Pairs Test, T=250.00, Z=3.60, p<0.001). In addition, male gym-goers generally have a significantly more affirmati-ve attitude towards SMEC than female gym-goers (Mann-Whitney U-test, U=119.50, Z=–2.68, p=0.007). Furthermore, there are gender differences in choosing a fitness trainer based on their appearance; but there are no gender differences in the attitude towards the number of fitness trainers’ followers on social media as an indicator of tru-stworthiness. As this study was specifically concerned with the attitudes of gym-goers, future studies should focus on sports professionals and their attitudes toward this topic.
Keywords: social media, fitness trainer, exercise, gender
Published in DiRROS: 16.04.2024; Views: 1092; Downloads: 604
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9.
Health aspects of aerobic interval training in the rehabilitation of patients with cardiovascular diseases : a sysematic review
Tamara Ilić, Doroteja Rančić, Stefan Stojanović, Ismail Ilbak, 2023, review article

Abstract: Purpose: The aim of this study was to review the literature analyzing the effects of aerobic interval training in the rehabilitation of cardiovascular patients.Methods: Research data was collected considering the inclusion and exclusion cri-teria of the research studies published in English. In order for the study to be included in the analysis, it had to meet the following criteria: year of publication (2004–2022), respondents were people with cardiovascular disease, and the studies included in this review must contain data on disease, training programme and outcomes. Papers with-out full texts available and systematic review studies were excluded. The first search identified 71 articles. In the initial assessment carried out in accordance with the inclu-sion and exclusion criteria, 15 articles were found suitable and were included in the study, while 20 studies were excluded for being duplicates, 28 studies excluded for not having the full text available and eight for non-compliance. Results: The reviewed materials indicate that aerobic interval training has an im-pact on VO2 max, functional abilities, VO2 peak and functional capacity in the reha-bilitation of cardiovascular diseases, especially in the elderly. The duration of the pro-gramme in most studies has a similar time range from 10 to 16 weeks. The programmes that showed the best effects are related to aerobic interval training, from 2 to 3 times per week with moderate (50–60% of VO2 max) or high intensity (80–90% of VO2 max). Conclusion: Studies indicate that properly dosed physical activity contributes to a better lifestyle for people with cardiovascular diseases. All 15 studies showed positive effects of aerobic interval training in cardiovascular disease rehabilitation.
Keywords: aerobic exercise, interval training, rehabilitation, cardiovascular diseases
Published in DiRROS: 16.04.2024; Views: 851; Downloads: 547
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