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Gegenwartig kursieren zahlreiche Vorschlage zur potenziellen Wirksamkeit von Traditioneller Chinesischer Medizin (TCM)/Akupunktur in der Therapie von SARS-CoV-2-Infektionen und assoziierten Symptomen. Stand dieser Uberlegungen sind insbesondere molekularvirologische, aber auch klinische Untersuchungen aus der SARS-Epidemie 2002/2003. Ein Wirksamkeitsnachweis von chinesischen Arzneimitteln mit antiviralem Potenzial in Bezug auf SARS-CoV‑2 steht grostenteils aus. Klinische Daten stutzen sich nahezu ausschlieslich auf Studien vor Beginn der Coronapandemie. Gegenwartig finden sich nur international publizierte Fallberichte sowie in China berichtete Beobachtungsstudien. Vielversprechend ist eine grose Zahl registrierter prospektiver Studien, die gegenwartig durchgefuhrt werden. Die Evidenzlage fur die nichtpharmakologischen Therapiesaulen der TCM ist sehr schwach. Auf Basis der Datenlage ist eine Kombination westlicher und TCM-Masnahmen in der westlichen Welt nur nach Ausschopfung der konventionellen Masnahmen gerechtfertigt.

Exercise has been shown to counteract age-related volume decreases in the human brain, and in this imaging study, we ask whether the same holds true for the microstructure of the cortex. Healthy older adults (n = 47, 65-90 years old) either exercised three times a week on a stationary bike or maintained their usual physical routine over a 12-week period. Quantitative longitudinal relaxation rate (R1 ) magnetic resonance imaging (MRI) maps were made at baseline and after the 12-week intervention. R1 is commonly taken to reflect cortical myelin density. The change in R1 (ΔR1 ) was significantly increased in a region of interest (ROI) in the primary motor cortex containing motor outputs to the leg musculature in the exercise group relative to the control group (p = .04). The change in R1 in this ROI correlated with an increase in oxygen consumption at the first ventilatory threshold (VT1) (p = .04), a marker of improvement in submaximal aerobic performance. An exploratory analysis across the cortex suggested that the correlation was predominately confined to the leg representation in the motor cortex. This study suggests that microstructural declines in the cortex of older adults may be staved off by exercise.

Measures aiming at containing the Coronavirus disease 2019 (COVID-19) include isolation, social distancing, and quarantine. Quarantine and other lockdown instruments show promise in reducing the number of COVID-19 infections and deaths. It is reasonable to assume that lockdown leads to reduced levels of physical activity in the general population. Potential detrimental health effects of lockdown, such as psychological distress and physical inactivity induced maladaptations must be addressed. The current review summarizes harmful effects of limited physical activity on mental and physical health due to social distancing and quarantine and highlights the effects of simple physical activity regimes counteracting these detrimental effects, with a special emphasis on acute effects.

The aim of this cross-sectional study was to determine the associations of objectively assessed habitual physical activity and physical performance with brain plasticity outcomes and brain-derived neurotrophic factor (BDNF) levels in cognitively healthy older adults. Physical performance was analyzed based on cardiopulmonary exercise-testing data and accelerometer-based physical activity was analyzed as total activity counts, sedentary time, light physical activity and moderate to vigorous physical activity. Brain plasticity outcomes included magnetic resonance spectroscopy (MRS)-based markers, quantitative imaging-based hippocampal volume and BDNF serum levels. The association between physical performance and hippocampal volume was strongly influenced by participants' education, sex, age and BMI. Confounder-controlled correlation revealed significant associations of brain plasticity outcomes with physical activity but not with performance. MRS-based adenosine triphosphate to phosphocreatine and glycerophosphocholine to phosphocreatine ratios were significantly associated with accelerometer total activity counts. BDNF was detrimentally associated with sedentary time but beneficially related to accelerometer total activity counts and moderate to vigorous physical activity. Exceeding the current moderate to vigorous physical activity recommendations led to significantly higher BDNF levels. Our results indicate that regular physical activity might be beneficial for preserving brain plasticity in higher age. In this study these associations were not mediated significantly by physical performance. Overall physical activity and exceeding current moderate to vigorous physical activity recommendations were positively associated with BDNF. Sedentary behavior, however, seems to be negatively related to neurotrophic factor bioavailability in the elderly.

Objectives Some authors report delayed responses of lipid metabolism after prolonged and interrupted sitting. To date no experimental studies have shown acute physical activity (PA) related changes of lipoprotein metabolism during sedentary behavior (SB). The purpose of this study was to examine immediate effects of a single PA-bout vs. regular PA-breaks on lipoprotein metabolism during postprandial SB. Design Eighteen female subjects (25.6years±2.6; 21.5kg/m2±2.0) participated in a balanced crossover experiment with three trials: (1) 30min PA prior to 4h sitting (PRE), (2) 5×6min PA within 4h sitting (BREAK) (3) 4h sitting (CTRL). PA was ergometer cycling at 70%VO 2 max. Participants consumed one standardized breakfast in each trial. Methods Total cholesterol (tChol), high density lipoprotein (HDL), low density lipoprotein (LDL) and triacylglycerol (TAG) readings were taken in fasted state at the beginning (before), and immediately after each trial. Multiple 2×3-ANOVAs (trial-arm*time) and post hoc t-tests were used. Results ANOVAs revealed trial*time-effects for tChol (p=0.043) and HDL (p=0.007) and a tendency for LDL (p=0.078). Before-to-after differences (Δ) of tChol during BREAK-trial (−0.89±5.49mg/dl) significantly differed to Δ during PRE-trial (+3.56±5.32mg/dl) (p=0.005) but not to ΔCTRL (+2.16±8.72). ΔHDL during BREAK-trial (−2.11±3.31mg/dl) significantly differed to ΔPRE (+0.83±4.26mg/dl) (p=0.007) and ΔCTRL (+0.06±4.15mg/dl) (p=0.028). Analysis of TAG revealed a time effect (p=0.007) and significant differences between TAG before and after trial within BREAK (79.22±38.69mg/dl to 94.78±44.86mg/dl) and CTRL (80.94±32.94mg/dl to 97.72±41.19mg/dl) but not in PRE (78.83±33.13mg/dl to 89.06±33.83mg/dl). Conclusions Breaking sedentary behavior with vigorous intensity PA seem to decelerate postprandial lipoprotein metabolism during sitting. In contrast, prior PA, might be a stimulus for lipid metabolization.

The health effects of light-intensity physical activity (PA) are not well known today. We conducted a systematic review to assess the association of accelerometer-measured light-intensity PA with modifiable health outcomes in adults and older adults. A systematic literature search up to March 2016 was performed in the PubMed, EMBASE, Web of Science and Google Scholar electronic databases, without language limitations, for studies of modifiable health outcomes in adults and older adults in the National Health and Nutrition Examination Survey accelerometer dataset. Overall, 37 cross-sectional studies and three longitudinal studies were included in the analysis, with considerable variation observed between the studies with regard to their operationalization of light-intensity PA. Light-intensity PA was found to be beneficially associated with obesity, markers of lipid and glucose metabolism, and mortality. Few data were available on musculoskeletal outcomes and results were mixed. Observational evidence that light-intensity PA can confer health benefits is accumulating. Currently inactive or insufficiently active people should be encouraged to engage in PA of any intensity. If longitudinal and intervention studies corroborate our findings, the revision of PA recommendations to include light-intensity activities, at least for currently inactive populations, might be warranted.

SummaryDerzeit existiert keine spezifische Therapie zur Prävention und Behandlung von SARS-CoV-2-Infektionen, weder in der konventionellen westlichen noch in der Traditionellen Chinesischen Medizin. Die aktuelle Studienlage zur Anwendung der chinesischen Arzneitherapie bei SARS-CoV-2-Infektionen beruht überwiegend auf klinischen Beobachtungen und entspricht einem niedrigen Evidenzniveau (IV) mit Empfehlungsgrad C. Somit wäre ein additiver Einsatzchinesischer Arzneimittel zur Symptombesserung zwar zu rechtfertigen, dies jedoch nur unter konsequenter Einhaltung etablierter Erstmaßnahmen mit konventionellen Methoden der Intensiv- und Notfallmedizin und weiterer Verfahren der klassischen Medizin.

Summary Activities of daily living, such as household, gardening, stair climbing, walking and cycling are now acknowledged as a major health resource, and explicitly advocated by many health authorities. Of activities of daily living, walking has received by far the most scientific interest both in prevention and therapy of chronic diseases. A considerable body of scientific evidence suggests that activities of daily living yield health benefits meaningful at the public health level. Promotion of these activities might be a promising way to improve health in unfit and elderly population disinclined to exercise.

Physical activity exerts a variety of long-term health benefits in older adults. In particular, it is assumed to be a protective factor against cognitive decline and dementia. Randomised controlled assessor blinded 2-armed trial (n = 60) to explore the exercise- induced neuroprotective and metabolic effects on the brain in cognitively healthy older adults. Participants (age ≥ 65), recruited within the setting of assisted living facilities and newspaper advertisements are allocated to a 12-week individualised aerobic exercise programme intervention or a 12-week waiting control group. Total follow-up is 24 weeks. The main outcome is the change in cerebral metabolism as assessed with Magnetic Resonance Spectroscopic Imaging reflecting changes of cerebral N-acetyl-aspartate and of markers of neuronal energy reserve. Imaging also measures changes in cortical grey matter volume. Secondary outcomes include a broad range of psychometric (cognition) and movement-related parameters such as nutrition, history of physical activity, history of pain and functional diagnostics. Participants are allocated to either the intervention or control group using a computer-generated randomisation sequence. The exercise physiologist in charge of training opens sealed and opaque envelopes and informs participants about group allocation. For organisational reasons, he schedules the participants for upcoming assessments and exercise in groups of five. All assessors and study personal other than exercise physiologists are blinded. Magnetic Resonance Spectroscopic Imaging gives a deeper insight into mechanisms of exercise-induced changes in brain metabolism. As follow-up lasts for 6 months, this study is able to explore the mid-term cerebral metabolic effects of physical activity assuming that an individually tailored aerobic ergometer training has the potential to counteract brain ageing. NCT02343029 (clinicaltrials.gov; 12 January 2015).

Patients with advanced cancer in which the primary aim of therapy is controlling symptoms are still capable of participating in appropriately designed exercise programs and may significantly benefit, both physically and psychologically, from such interventions. Overall, exercise regimens for patients with advanced cancer should be tailored on a personal basis to accommodate health status and limitations imposed by disease and should be part of an overall comprehensive plan of palliative care developed and administered by an interdisciplinary team. In general, palliative – symptomatic therapy measures may be most effective when introduced early in the course of disease management, even during the curative phase of therapy. In this chapter, approaches to palliative medicine are discussed in general and specifically for patients with tumors of the lung and respiratory track, prostate cancer, gynecologic tumors and gastrointestinal tumors. The effects of exercise interventions are reviewed also for symptom clusters that occur frequently in advanced cancer patients including chronic fatigue syndrome, the anorexia-cachexia syndrome and the chronic severe pain syndrome. Overall, it is important to note, that regardless of the course of the disease, the majority of advanced cancer patients who obtain measurable increase in performance with exercise training, report considerable improvement in quality of life.