Earticle

The purpose of this study was to determine the effects of resistance exercise programs on older adults’ physical and psychological health indicators. Twelve randomized controlled trials published in Korean be-tween January 2000 and July 2024 were included in this meta-analysis. The subjects in the selected studies were all aged 65 and over. The in-tervention group performed resistance exercise, and the control group did not engage in structured exercise programs. The resistance exer-cise programs were implemented for an average of 8–12 weeks, 2–3 sessions per week, with each session lasting 40–70 min. Effect sizes were calculated using standardized mean differences, and statistical analysis was conducted using R software. The results revealed that re-sistance exercise significantly improved various fall-related physical outcomes, including grip strength, flexibility, static and dynamic balance, lower body strength, and coordination. Also, fall efficacy was signifi-cantly increased. However, there was no statistically significant change in skeletal muscle mass and body fat percentage. These findings sug-gest that resistance exercise is an effective intervention for improving physical function and psychological stability in older adults.

Hepatocellular carcinoma (HCC) is a prevalent cancer with high mortality rates globally. This review explores various HCC treatments, including surgical resection, liver transplantation, local ablation, and systemic therapies. With advancements in surgical techniques, local therapies, and immunotherapy, the treatment paradigm for HCC is rapidly evolving. Surgical resection remains the preferred first-line treatment for localized HCC with preserved liver function, offering significant survival benefits. Liver transplantation is suitable for patients meeting specific criteria and helps restore liver function in individuals with compromised liver capabilities, providing excellent long-term outcomes. Local ablation is recommended for very early-stage HCC ineligible for surgery, offering outcomes comparable to resection. Transarterial therapies, such as transarterial radioembolization, are employed to treat intermediatestage HCC, enhancing treatment outcomes. Radiation therapy is increasingly utilized due to improved safety profiles, providing effective treatment options for HCC patients. Systemic treatments have advanced with the introduction of molecularly targeted therapies and immune checkpoint inhibitors, improving survival rates. The development of immunotherapy combinations has shown promising efficacy as first-line treatments. The ongoing advancement in treatment strategies, alongside personalized patient approaches, is expected to further enhance outcomes for HCC patients.

This study aimed to evaluate the reliability and validity of the Kirkpatrick four-level questionnaire—comprising reaction (R), learning (L), behav-ior (B), and results (Res)—in the context of an exercise rehabilitation program. A total of 141 university students, aged 21 to 25, participated in a 15-week exercise rehabilitation program. Intrarater reliability was as-sessed using the intraclass correlation coefficient (ICC) in a pre-post - test setup and analyzed through Bland–Altman plots. Convergent validi-ty was examined using Pearson correlation. The results of this study were as follows. ‘R,’ consisting of six questions, showed an ICC ranging from 0.954 to 0.990. ‘L,’ composed of seven questions, demonstrated an ICC between 0.883 and 0.978. ‘B,’ made up of five questions, displayed an ICC ranging from 0.859 to 0.974. Additionally, ‘Res,’ consisting of five questions, showed an ICC between 0.834 and 0.926. Significant correla-tions were observed among all 23 items (P<0.001), suggesting that the application of the Kirkpatrick model to evaluate the exercise rehabilita-tion program demonstrates strong reliability and validity. These findings suggest that the evaluation metrics can effectively monitor program outcomes at each level through the application of the Kirkpatrick model.

Load asymmetry in the lower limbs of patients with hip fracture is asso-ciated with decreased gait ability, impaired balance, and increased risk of fall. The modified sit-to-stand (STS), which combines positioning the foot behind with chair seat elevation, facilitates loading on the affected limb. This study aimed to investigate lower limb load asymmetry during STS and walking in patients with hip fracture after modified STS train-ing. This quasi-randomized pilot trial assigned patients with hip fractures to modified or normal STS (feet together) groups, matched by age and stratified (mean age, 81.9±5.5 years vs. 82.7±6.8 years). Twelve and ten participants in the modified and normal STS groups, respectively, were included in the analysis. The intervention lasted for 15 min/day for 2 weeks in both groups. The amount of load on the affected and unaf-fected limbs during STS and the amount of load and stance time during walking were measured before and after the intervention. Other physi-cal functional outcomes included lower limb strength, balance, and gait speed. The amount of load on the affected limb, stance time of the af-fected limb, knee extension strength of the affected limb, and Berg Bal-ance Scale score showed a group and time interaction, and were sig-nificantly greater in the modified STS group after than before the inter-vention. Modified STS training in patients with hip fracture improves the load on the affected limb during STS, stance time of the affected limb during walking, knee extensor strength in the affected limb, and balance function.

Obesity is associated with reduced exercise tolerance, yet the physio-logical mechanisms underlying this impairment remain unclear. This study examined whether oxygen uptake (V̇O2) kinetics reflect autonom-ic regulation during prolonged moderate-intensity exercise in normal- weight and obese males. This cross-sectional study included nine nor-mal-weight and nine obese males (aged 20–22) who performed 30 min of constant-load cycling at 70% of ventilatory threshold to assess V̇O2 kinetics and heart rate variability (HRV) responses. V̇O2 kinetics param-eters—including the time constant (τ), which reflects the rate of car-diopulmonary and muscular adjustment to exercise, and the V̇O2 drift slope—were analyzed. HRV was assessed at rest and during exercise. Changes in HRV and their correlations with V̇O2 kinetics and perceived fatigue were evaluated. The obese group had a significantly longer τ than the normal-weight group, despite similar relative intensities. During exercise, HRV indices—including overall HRV, low-frequency, very low-frequency, and the standard deviation along the line of identity (SD2) —were significantly lower in the obese group, indicating attenuated autonomic responsiveness. In the normal-weight group, the slope was strongly correlated with the changes in the root mean square of suc-cessive differences, the high-frequency power, the standard deviation perpendicular to the line of identity (SD1), and SD1/SD2 (r=-0.769 to -0.857; P<0.05), whereas these associations were absent in the obese group. These findings suggest that in normal-weight individuals, V̇O2 ki-netics are closely linked to autonomic modulation during prolonged ex-ercise, whereas this link is disrupted in obesity, potentially leading to re-duced aerobic efficiency and greater exercise intolerance.