Search PubMed⌕ Search

Biomedical subjects

M S Nash

Publications and source records attributed to M S Nash.

At least 37 records · Page 2Linked to original sources

Photoreceptors are preferentially affected in the rat retina following permanent occlusion of the carotid arteries.

Carotid artery occlusion (two vessel occlusion; 2-VO) for 3 or 9 months causes a suppression of the electroretinogram. However, after 3 months the retinal morphology appears unaffected judging from the localisation of GABA, ChAT, alpha PKC, Thy-1 and GFAP immunoreactivities. Moreover, no difference in NMDA-R1, opsin or Thy-1 mRNA levels were detected. In contrast, after 9 months 2-VO photoreceptor degeneration occurred as indicated by thinning of the outer nuclear layer and reduced Ret-P1 immunoreactivity. All other immunoreactivities appeared normal. These findings were supported by analysis of retinal mRNA levels. We conclude that the major effect of prolonged 2-VO is photoreceptor degeneration.

Animals↗

The potential of neuroprotection in glaucoma treatment.

Visual field loss in glaucoma is due to death of retinal ganglion cells. Reducing or slowing down the loss of ganglion cells in glaucoma, a concept known as neuroprotection, would appear to be the only way forward. This does not imply that treatment of risk factors, such as elevated intraocular pressure, must not be continuously implemented. In this paper we point out that very little is known about the mechanisms of ganglion cell death in glaucoma and that data derived from studies on the "ideal animal model for glaucoma" must not be overemphasized. We also propose that the death processes of neurones in various diseases are fundamentally the same but vary in cause. Experimental data show that the death rate of neuronal populations is dependent on the impact of the insult and that neuroprotectants are more likely to benefit a patient in diseases in which the neurones die slowly, as in glaucoma, than in a disease in which the death of a set of neurones is rapid. We conclude that if a putative neuroprotectant can be administered in such a way that it reaches the retina in appropriate amounts and has insignificant side effects, it is likely to attenuate ganglion cell death and thus benefit the glaucoma patient.

Animals↗

Assessment of Thy-1 mRNA levels as an index of retinal ganglion cell damage.

PURPOSE: Thy-1 is primarily, if not entirely, expressed by the ganglion cells within the retina. This knowledge was used to index ganglion cell death after ischemia and excitotoxicity by studying changes in Thy-1 mRNA levels. METHODS: Insults to the rat retina were delivered either by elevation of intraocular pressure for 60 minutes or by intravitreal injection of N-methyl-D-aspartate (NMDA). After a defined period, changes in Thy-1 immunoreactivity and mRNA levels of Thy-1 and NR1 (NMDA receptor subunit) were used to index ganglion cell sensitivity to damage. Opsin mRNA levels were used as an internal control because photoreceptors lack NMDA receptors. RESULTS: Retinal Thy-1 immunoreactivity, associated with the ganglion cell and inner plexiform layers, is reduced by ischemia or intravitreal injections of NMDA in a dose-dependent manner. Using a semi-quantitative polymerase chain reaction (reverse transcription-polymerase chain reaction) methodology, the levels of total retinal Thy-1 and NR1 mRNAs were shown to be dramatically reduced after both transient ischemia and intravitreal injection of NMDA. The effect of NMDA was found to be both time- and dose-dependent. In contrast, no change occurred in the levels of opsin mRNA unless high levels of NMDA (200 nmoles) were administered. CONCLUSIONS: Ischemia and NMDA-induced excitotoxicity caused retinal ganglion cell destruction, but the photoreceptors were unaffected. Measurement of total retinal Thy-1 mRNA levels provides a useful way of following ganglion cell death especially when combined with immunohistochemical localization of Thy-1. Additionally, the effect on other retinal cell types such as the photoreceptors can be followed in concert using this technique.

Animals↗

Aerobic circuit exercise training: effect on adolescents with well-controlled insulin-dependent diabetes mellitus.

OBJECTIVES: To test the safety and effects of exercise conditioning on cardiorespiratory fitness, body composition, muscle strength, glucose regulation, and lipid/cholesterol levels. SUBJECTS: Ten male adolescents with insulin-dependent diabetes mellitus (IDDM) and 10 adolescent nondiabetic (ND) subjects. DESIGN: Pretest, posttest intervention trial with control group. SETTING: University-based human performance laboratory. INTERVENTION: Mixed endurance and calisthenic/strength activities performed at a rapid pace three times weekly for 12 weeks. RESULTS: Only one subject with IDDM experienced hypoglycemia after a single exercise session. Both subject groups improved their cardiorespiratory endurance (p < .05). Lean body mass of IDDM subjects increased by 3.5% (p < .05). Subjects with and without IDDM lowered their percent body fat (p < .05 and .001, respectively). Strength improvement of IDDM subjects ranged from 13.7% (p < .001) to 44.4% (p < .01), depending upon the maneuver. Fasting blood plasma glucose for all subjects was unchanged by training, but glycosylated hemoglobin A1c of IDDM subjects was reduced by .96 percentage point (p < .05). Reductions of HbA1c benefitted subjects exhibiting poor preconditioning glycemic control. Low-density lipoprotein cholesterol was decreased in subjects with IDDM (p < .05), but not total cholesterol or triglycerides. CONCLUSION: Adolescents with IDDM undergoing aerobic circuit training improve their cardiorespiratory endurance, muscle strength, lipid profile, and glucose regulation. Aerobic circuit training is safe for properly trained and monitored adolescent diabetics.

Adolescent↗

Oxyhemoglobin desaturation and aberrant carbon dioxide homeostasis during electrically stimulated exercise in a ventilator-dependent tetraplegic patient.

This single-subject case examined oxyhemoglobin saturation and alveolar end-tidal carbon dioxide levels in a ventilator-dependent tetraplegic patient undergoing electrical stimulation cycle ergometry. When exercising with a closed tracheostomy cuff under resting ventilator settings (resting intermittent mandatory ventilation; frequency = 6breaths/min, tidal volume = 83.3mL, minute ventilation =5L/min), his oxyhemoglobin saturation decreased from 100% to 92%, while alveolar endtidal carbon dioxide increased linearly to 47mmHg. These undesirable changes were corrected under adjusted intermittent mandatory ventilation conditions (frequency = 12breaths/min, tidal volume = 83.3mL, minute ventilation = 10L/min), during which oxyhemoglobin saturation remained above 98% and the alveolar end-tidal carbon dioxide trend resembled that of ventilator-independent tetraplegic individuals undergoing the same exercise. Because the subject's heart rate was higher under adjusted ventilation conditions, these responses may have been caused by augmented venous return resulting from greater abdominothoracic pumping at the higher breathing frequency. These findings support the need to modify ventilator settings in ventilator-dependent tetraplegic persons while undergoing exercise to maintain oxyhemoglobin saturation and carbon dioxide homeostasis.

Adult↗

Flupirtine, a nonopioid centrally acting analgesic, acts as an NMDA antagonist.

1. Flupirtine (Katadolon) is a member of a class of triaminopyridines and is used as a nonopioid analgesic agent with muscle relaxant properties. 2. In situ experiments have revealed that flupirtine protects against ischemic-induced insults to the retina and brain. 3. Data derived from in vitro and in vivo studies suggest that flupirtine functions as a weak N-methyl-D-aspartate (NMDA) antagonist with little evidence that it acts on AMPA-kainate type glutamate receptors. 4. No evidence could be found from binding studies to suggest that flupirtine has an affinity for any of the characterized binding sites associated with the NMDA receptor. 5. Studies on cultured cortical neurons show that the NMDA-induced influx of 45Ca2+ is more readily decreased by flupirtine when a reducing agent (dithiothreitol) is present. However, when N'-ethylmaleimide, which is thought to alkylate the NMDA receptor redox site, is present, no obvious effect on the NMDA-induced influx of 45Ca2+ is produced by flupirtine. 6. Flupirtine is also known to counteract the production of reactive oxygen species caused by ascorbate/iron as well as to prevent apoptosis in cells lacking NMDA receptors induced by oxidative stress. 7. To explain all the experimental data, it is suggested that flupirtine affects the redox state/pH/electrons in the cell. The specific way by which flupirtine antagonizes the NMDA receptor might be by an action on the known redox site of the receptor.

Aminopyridines↗

Melatonin counteracts ischemia-induced apoptosis in human retinal pigment epithelial cells.

PURPOSE: To investigate whether the neurohormone melatonin can prevent apoptosis caused by deprivation of oxygen, glucose, and serum (experimental ischemia) in cultured human retinal pigment (RPE) cells. METHODS: Cultures of human RPE cells established from a variety of donors were grown to passage four and then subjected to experimental ischemia, with or without various substances, for up to 72 hours. Cells were examined for morphologic changes and breakdown of DNA, assessed by TdT-dTUP terminal nick-end labeling (TUNEL) and agarose gel electrophoresis. Changes in transcription and translation of various proto-oncogenes (bcl-2, TIAR, ICH-1S/1) were assessed by analysis of mRNA and protein levels, respectively. The effect of various substances on the iron-ascorbate-induced formation of reactive oxygen species (ROS) in chick retinal dissociates was also investigated. RESULTS: Cultured human RPE cells on coverslips that were incubated in serum-free medium, glucose, and oxygen remained viable for up to 40 hours. Thereafter, there was a steady decrease in cell numbers and an increase in the number of cells labeled by the TUNEL method. By 72 hours 65% of cells remained attached to the coverslips, of which approximately 65% were TUNEL positive. Furthermore, most of the experimental ischemia-treated cells exhibited a shrunken appearance typical of apoptosis. Fragmentation of the DNA from cells in which ischemia was induced for 72 hours was also confirmed by agarose gel electrophoresis. Inclusion of 100 microM melatonin significantly decreased the amount of apoptotic cell nuclei after ischemia, but the effect was mild compared with that of fetal calf serum, which almost completely counteracted cell death. The action of melatonin was not prevented by 0.01 mM to 1 mM luzindole, a melatonin receptor antagonist. In addition, 100 microM ascorbate did not counteract ischemia-induced apoptosis. Treatment of RPE cells with 100 microM flupirtine gluconate for 72 hours caused an upregulation of the proto-oncogene protein Bcl-2 and a decrease in TIAR and ICH-1L proteins compared with that in control cells. Melatonin at 100 microM had no such effect. The levels of the mRNA transcripts for ICH-1L relative to those for ICH-1S were significantly decreased in cultures treated with 100 microM flupirtine or 100 microM melatonin when compared with levels in control cells. However, the effect of flupirtine was greater than that of melatonin. Ten micromolar ascorbate and 5 microM iron stimulated the formation of ROS in chick retinal cell dissociates. Ascorbate, melatonin, and flupirtine (all at 100 microM) blunted this response in the order flupirtine > melatonin >> ascorbate. Luzindole had no effect, alone or in the presence of melatonin. CONCLUSIONS: The presented data show that melatonin counteracted ischemia-induced apoptosis in human RPE cells by a process that seemed to be independent of melatonin receptors. Moreover, melatonin and flupirtine counteracted iron-ascorbate-induced ROS formation and decreased the ratio of mRNA for ICH-1L and ICH-1S. However, melatonin was less potent than flupirtine in its action in each case, which suggests that either the two compounds act on different signaling pathways or that they act on the same pathway with differing potency. The failure to detect an effect of melatonin on the levels of Bcl-2, ICH-1L, and TIAR proteins when compared with the effect of flupirtine was probably caused by the sensitivity of the procedures. It is suggested that substances that can prevent ROS formation can potentially nullify apoptotic cell death, but this is difficult to detect experimentally when the substance has only a mild effect, such as in the case of ascorbate.

Aged↗

Protein kinase C activation by serotonin potentiates agonist-induced stimulation of cAMP production in cultured rat retinal pigment epithelial cells.

Serotonin stimulates inositol phosphate production and intracellular calcium mobilization in cultured rat retinal pigment epithelial (RPE) cells through interaction with 5-HT2A receptors, but decreases cAMP production in cultured human RPE cells via 5-HT1A receptors. Studies were therefore undertaken to investigate the effect of serotonin on the cAMP system in rat RPE cells. Exposure of cultured rat RPE cells to serotonin (100 microM) for 10 minutes had no effect on the basal levels of cAMP. However, a 5 minute preincubation with serotonin potentiated the production of cAMP induced by a 5 minute exposure to forskolin (5 microM), isoproterenol (1 microM) and 5'-[N-ethylcarboxamido]-adenosine (10 microM) by 133.0%, 296.8% and 651.9%, respectively. This effect of serotonin was dose-dependent on forskolin and 5'-[N-ethylcarboxamido]-adenosine with half-maximal effects close to those reported for its action on inositol phosphates production. The antagonists ketanserin, methysergide and spiperone attenuated the action of serotonin, while yohimbine and spiroxatrine were ineffectual, thus indicating that the potentiating effect was through the 5-HT1A receptor. Incubation of cultured rat RPE cells with bradykinin stimulates inositol phosphates production with half-maximal effect observed at 1 nM. Bradykinin also potentiates the action of forskolin, isoproterenol and 5'-[N-ethylcarboxamido]-adenosine on cAMP production in a dose-dependent manner with little effect on basal levels. RPE cells exposed to serotonin (500 microM) or phorbol 12-13 dibutyrate (1 microM) for 30 minutes showed translocation of protein kinase C to the membrane from the cytosol, with 53.3% and 29.4% increases in membrane activity, respectively. Forskolin- and 5'-[N-ethylcarboxamido]-adenosine-induced cAMP production was potentiated by phorbol 12-13 dibutyrate (1 microM) treatment. The effect of both serotonin and phorbol 12-13 dibutyrate on forskolin-induced cAMP production was attenuated by pretreatment of cell cultures with the protein kinase C antagonists staurosporin and calphostin C at 1 microM. Thus, the production of cAMP in cultured rat RPE cells is potentiated by 5-HT2A receptors through activation of protein kinase C. This effect is, however, not specific since bradykinin, which stimulates inositol phosphates turnover, also potentiates stimulated cAMP production.

Adenosine↗

Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: part 1. Ambulation performance and anthropometric measures.

OBJECTIVE: To describe performance parameters and effects on anthropometric measures in spinal cord injured subjects training with the Parastep 1 system. DESIGN: Before-after trial. SETTING: Human spinal cord injury applied research laboratory. PARTICIPANTS: Thirteen men and 3 women with thoracic (T4-T11) motor-complete spinal cord injury: mean age, 28.8yrs; mean duration postinjury, 3.8yrs. INTERVENTION: Thirty-two functional neuromuscular stimulation ambulation training sessions using a commercially available system (Parastep-1). The hybrid system consists of a microprocessor-controlled stimulator and a modified walking frame with finger-operated switches that permit the user to control the stimulation parameters and activate the stepping. OUTCOME MEASURES: Distance walked, time spent standing and walking, pace, circumferential (shoulders, chest, abdomen, waist, hips, upper arm, thigh, and calf) and skinfold (chest, triceps, axilla, subscapular, supraillium, abdomen, and thigh) measurements, body weight, thigh cross-sectional area, and calculated lean tissue. RESULTS: Statistically significant changes in distance, time standing and walking, and pace were found. Increases in thigh and calf girth, thigh cross-sectional area, and calculated lean tissue, as well as a decrease in thigh skinfold measure, were all statistically significant. CONCLUSIONS: The Parastep 1 system enables persons with thoracic-level spinal cord injuries to stand and ambulate short distances but with a high degree of performance variability across individuals. The factors that influence this variability have not been completely identified.

Adult↗

Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: part 2. Effects on physiological responses to peak arm ergometry.

OBJECTIVE: To examine the task-nonspecific effects of functional neuromuscular stimulation (FNS)-assisted ambulation training on the physiological responses of persons with paraplegia to upper extremity exercise challenge. DESIGN: Before-after trial. SETTING: Human spinal cord injury (SCI) applied research laboratory. PARTICIPANTS: Twelve men and three women with motor- and sensory-complete thoracic-level SCI (T4-T11), mean age 28.2 +/- 6.8yrs (range, 21.1 to 45.2yrs), mean injury duration 3.7 +/- 3.0yrs (range, 7 to 8.8yrs). INTERVENTION: Thirty-two sessions of FNS ambulation training using a commercial six-channel system (Parastep 1). This system is composed of a microprocessor-controlled electrical stimulation unit and a walking frame outfitted with finger switches that allow the user to independently control the system and stimulation parameters. OUTCOME MEASURES: Peak and subpeak physiological responses to arm ergometry testing and upper extremity strength measures, obtained before and after the FNS ambulation training. RESULTS: Statistically significant increases in peak values for time to fatigue, peak power output, and peak VO2 (all p < .001). Heart rate was significantly lower throughout subpeak levels of arm ergometry after the ambulation training (p < .05). Values of upper extremity strength were not significantly altered after training. CONCLUSIONS: FNS ambulation by persons with SCI paraplegia results in task-nonspecific training adaptations. Central cardiovascular adaptations were indicated as the primary source of these beneficial alterations in exercise responses.

Adult↗

Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: part 5. Lower extremity blood flow and hyperemic responses to occlusion are augmented by ambulation training.

OBJECTIVE: To test whether 12 weeks of exercise conditioning using functional neuromuscular stimulation (FNS) ambulation alters the resting lower extremity blood flow and hyperemic responses to vascular occlusion in subjects with paraplegia, and to determine whether an association exists between limb flow and lower extremity fat-free mass. DESIGN: Pretest, posttest. SETTING: Academic medical center. PARTICIPANTS: Subjects with chronic neurologically complete paraplegia. INTERVENTION: Thirty-two sessions of microprocessor-controlled ambulation using electrically stimulated contractions of lower extremity muscles and a rolling walker. OUTCOME MEASURES: Subjects underwent quantitative Doppler ultrasound examination of the common femoral artery (CFA) before and after training. End-diastolic arterial images and arterial flow-velocity profiles obtained at rest and after 5 minutes of suprasystolic thigh occlusion were computer-digitized for analysis of heart rate (HR), CFA peak systolic velocity (PSV), CFA cross-sectional area (CSA), flow velocity integral (FVI), pulse volume (PV), and CFA (arterial) inflow volume (AIV). RESULTS: Significant effects of training on CSA (p < .0001), FVI (p < .05), computed PV (p < .001), and computed AIV (p < .01) were observed. Resting HR was lower following training (p < .05). The change for resting PSV approached but did not reach significance (p = .083). Analysis of postocclusion PV and AIV showed significant effects for conditioning status (p values < .01), postcompression time (p values < .0001), and their interaction (p values < .01). At 1 minute after occlusion, the posttraining AIV response was 78.2% greater in absolute magnitude and 17.4% more robust when expressed as a percentage change from its resting value than before training. Significant correlations were found between thigh fat free mass and both AIV and PV (p values < .05). CONCLUSION: Exercise training using FNS ambulation increases the resting lower extremity AIV in individuals with paraplegia and augments the hyperemic response to vascular occlusion. Improved posttraining blood flow is attributable both to vascular structural changes and upregulation of vascular flow control mechanisms. Limb mass is associated with the volume of arterial blood flow.

Adult↗

The effects of prosthesis mass on metabolic cost of ambulation in non-vascular trans-tibial amputees.

The effect of prosthesis mass on the metabolic cost of steady-state walking was studied in ten male non-vascular trans-tibial amputees (TTAs) and ten non-amputee controls. The subjects underwent four trials of treadmill ambulation, with each trial performed for nine minutes at level grade and 76 m/min. Twenty minutes of seated rest followed each trial. During trials numbers one and two, TTAs ambulated without mass added to their prosthesis. During the third and fourth trials, either 454 or 907 grammes mass (1 or 2lbs mass respectively) were randomly assigned and added to either the prosthesis or the leg of the non-amputee control. Subjects were blinded to the amount of mass added to their limb. Within-group comparisons across the four trials showed significant differences in oxygen consumption (VO2) and heart rate (HR) between the two non "mass added" trials, but no effect for addition of mass. The VO2 of TTAs was only 0.6 ml/kg/min (4.7 percent) greater during walking following the addition of 907 grammes to the prosthesis than without mass addition at all, while HR averaged only 1.4 beats/min. higher under the same testing condition. Pearson-product moment correlations echoed these findings, as moderate, but in all cases, negative correlations were observed for associations among the factors of subject age, stump length, and prosthesis-shoe weight, and both VO2 and HR. It was concluded that adding up to 907 grammes mass to a non-vascular TTA's prosthesis will not significantly increase the energy expenditure or HR at a normal walking speed, and that elevated energy cost of ambulation in repeated measures testing without mass added may reflect task familiarization and not an added burden of prosthesis mass.

Adult↗

Pharmacologic evidence for 5-HT1A receptors associated with human retinal pigment epithelial cells in culture.

PURPOSE: The authors investigate the possible presence of 5-hydroxytryptamine (5-HT1) type serotonin receptors negatively coupled to adenylate cyclase activity in cultured human retinal pigment epithelial (RPE) cells. METHODS: Adenylate cyclase activity was assessed by the determination of cellular adenosine 3':5' cyclic monophosphate (cAMP) levels and the effects of serotonin on both basal and forskolin-stimulated cAMP levels studied. RESULTS: Serotonin at 100 microM had no effect on the basal levels of cAMP in cultured human RPE cells, but attenuated by 43.6% the stimulation in cAMP production induced by forskolin (5 microM). This effect was dose dependent for serotonin with half-maximal inhibition (EC50) occurring at approximately 1.5 x 10(-9) M. The 5-HT1 receptor agonist 8-hydroxy [2-di-n-propylamino] tetralin (8-OH DPAT), buspirone, 5-carboxyamidotryptamine, and RU24969 mimicked the inhibitory effect of serotonin in a dose-dependent manner. The actions of serotonin and 8-OH DPAT (10 microM) were dose-dependently attenuated by the serotonergic antagonists spiroxatrine, propranolol, and spiperone. Pretreatment of RPE cell cultures with pertussis toxin abolished the serotonin-induced reduction of forskolin-elevated cAMP levels. Stimulation of cAMP production by the beta-adrenoceptor agonist isoproterenol at 0.1 microM, but not at 10 microM or 100 microM, also was attenuated by serotonin (100 microM), whereas cAMP production induced by the adenosine receptor agonist 5'-[N-ethyl]-carboxamidoadenosine (NECA) at 1 microM, 10 microM, and 100 microM was unaffected. Serotonin and 8-OH DPAT dose-dependently inhibited isoproterenol-stimulated (0.1 microM) cAMP production with EC50 values of approximately 10 microM, and pertussis toxin pretreatment partially blocked these effects. CONCLUSIONS: Cultured human RPE cells possess 5-HT1A receptors negatively coupled to cAMP production through a pertussis toxin-sensitive G protein. These receptors show differential effects on forskolin-, isoproterenol-, and NECA-stimulated cAMP production, which may reflect a unique spatial distribution of receptor proteins or the phenotypic heterogeneity of RPE cells that is the result of or that is preserved in culture.

Adenylate Cyclase Toxin↗

The ocular blood flow tonograph: a new instrument for the measurement of intraocular pressure in rabbits.

The Ocular Blood Flow Tonograph (OBFT) and Digilab Pneumatonograph (PTG) were calibrated for use on New Zealand White rabbits using a pressure manometer and performing tonometry at varying known pressures. The calibration experiments showed that a good correlation exists between OBFT measurements and manometric readings of IOP. Moreover, no difference between open and closed stopcock measurements were observed. Corrective equations for conversion of OBFT readings to mm Hg are documented. The OBFT was compared with the PTG and the results showed there was no significant difference between the IOP measured by either instrument in a group of rabbits displaying a range of different IOPs. Regression analysis of the data gave a slope of 0.88 and a correlation co-efficient of 0.78. The OBFT proved easier to use than the PTG under restricted lighting conditions. The OBFT was also used to measure the circadian variation in IOP and to measure the IOP after the topical application of prostaglandin E2 and various serotonergic agonists. The combined data demonstrated that the OBFT is an accurate and reliable tonometer for the measurement of IOP in rabbits.

Animals↗

Lower extremity blood flow and responses to occlusion ischemia differ in exercise-trained and sedentary tetraplegic persons.

OBJECTIVE: To test whether lower extremity blood flow and hyperemic responses to vascular occlusion differ among electrically stimulated exercise trained and sedentary tetraplegic persons and subjects without tetraplegia (control). DESIGN: Blinded cross-sectional comparison, control group. SETTING: Academic medical center. PARTICIPANTS: Ten sedentary tetraplegic men, 10 tetraplegic persons previously habituated to electrically stimulated cycling exercise for 0.4 to 7 years, and 10 nondisabled controls. OUTCOME MEASURES: Subjects underwent quantitative Doppler ultrasound examination of the common femoral artery (CFA). End-diastolic arterial images and arterial flow-velocity profiles obtained at rest and following five minutes of suprasystolic thigh occlusion were computer digitized for analysis of heart rate (HR), CFA peak systolic velocity (PSV), CFA cross-sectional area (CSA), flow velocity integral (FVI), and computed CFA inflow volume (IV). RESULTS: No group main effects were observed for resting HR or FVI. At rest, trained tetraplegic men had 14.9% greater PSV, 29.8% larger CSA, and 51.3% greater IV (p values < .05) than sedentary tetraplegic subjects. Resting PSV and IV of the trained subjects did not differ from controls, although CSA was smaller than controls (p < .05). Following occlusion, PSV, CSA, and IV averaged 16.5%, 33.4%, and 65.1% greater for trained tetraplegics persons, respectively, than sedentary tetraplegic subjects (p values < .05). Only CSA differed between the control and the trained groups (p < .05). CONCLUSION: Tetraplegic persons conditioned by electrically stimulated cycling have greater lower extremity blood flow and hyperemic responses to occlusion than do their sedentary counterparts.

Adult↗

Head position and its effect on pulmonary function in tetraplegic patients.

To test the influence of head position on pulmonary function in tetraplegic individuals 15 subjects with chronic C4-C7 injuries participated in a one group pre-post test comparing the relationship between orthostatic position of the head (OPH) and standard pulmonary function tests (PFTs). Twelve subjects with habitual forward head posture and three with non-forward head posture performed PFTs in (1) their habitual posture, and (2) an experimental posture imposed by placement of thoracic and/or lumbar rolls behind their back. Results showed that changing head posture did not alter mid-forced expiratory flow or forced inspiratory vital capacity, but significantly affected forced vital capacity (t = 2.83; P < 0.05) and 12 s maximum voluntary ventilation (t = 2.07; P < 0.05). In cases where pulmonary function was altered by head position, the resulting performance was best in the subject's habitual posture, although no differences in resting pulmonary tests were observed between subjects with and without forward head position. These data show that temporary postural alterations affecting OPH, if not allowing sufficient time for muscular adaptation, adversely affect pulmonary function in tetraplegic patients.

Adolescent↗