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At least 1,333 records · Page 74Linked to original sources
PubMed2006

Performance diagnostics in handbiking during competition.

STUDY DESIGN: Case study in handbiking under competition conditions. OBJECTIVE: To investigate exercise-induced, metabolic, pulmonary, cardiovascular and energetic reactions of a paraplegic athlete during a city marathon. SETTING: City marathon Cologne, Germany. SUBJECT: We tested a 27-year-old male athlete from the German national team. The handicap of the athlete was a complete traumatic spinal cord injury ASIA/IMSOP Grade A at the level of the fourth thoratic vertebra (Th4). METHOD: In the competition, the athlete used his own race handbike whose crank system had been exchanged for a power measurement system with registering option. For measuring ventilatory gas parameters during exercise, a portable spirometric system was used. The athlete managed to finish the marathon race in 1:48:54 h. RESULTS: The mean oxygen uptake (VO2) during the marathon was 1580 ml/min, with a maximum value of 2535 ml/min. The mean heart frequency was 137 bpm with a maximum of 157 bpm. During the race the mean energy consumption was 463 kcal/h with a maximum of 758 kcal/h. Prior to the race, the blood lactate value was 2.9 mmol/l; after 10 km 4.4 mmol/l; after 20 km 2.9 mmol/l, and after 30 km 2.9 mmol/l. CONCLUSION: Competition-oriented handbikers should concentrate on exercise units of long duration at low intensities--like marathon runners or cyclists--in order to improve their aerobic performance capacity. However, it has to be pointed out that paraplegic athletes develop relatively high metabolic intensities in competition and that the variability of their physiological parameters is considerably high.

Adult↗
PubMed2002

A controlled trial of hospital versus home-based exercise in cardiac patients.

BACKGROUND: Large numbers of patients who stand to benefit from the exercise training component of cardiac rehabilitation are not being served due to access issues. Home-based exercise training may be a potentially useful alternative to training in institutional environments. PURPOSE: The purpose of this study was to examine the benefit of 6 months of hospital-based exercise training versus 6 months of monitored, home-based exercise training with respect to physical, quality of life, and social support outcomes in patients after coronary artery bypass graft (CABG) surgery. METHODS: Randomized controlled trial of "direct-to-home" (Home; = 120) versus "direct-to-hospital" (Hosp; = 122) exercise training, 35-49 d post CABG surgery. The primary outcome was peak exercise capacity, measured by peak oxygen consumption (VO(2)) on a symptom-limited cycle ergometer exercise test. Secondary outcomes were health-related quality of life (measured by the SF-36) and social support (measured by the ISEL). Measurements were taken at baseline and after 3 and 6 months of exercise training. RESULTS: The study groups had similar demographic and health profiles at baseline. Peak VO(2) improved significantly in both groups after 6 months of exercise training; 36% in the Hosp group (1,222.1 +/- 269.0 mL x min(-1) to 1,497.2 +/- 594.3 mL x min(-1); < 0.0001) and 31% in the Home group (1,260.3 +/- 306.5 mL x min(-1) to 1,433.4 +/- 589.7 mL x min(-1); < 0.05). The Home group reported greater total social support than the Hosp group at 3 (36.2 +/- 4.5 vs 34.0 +/- 6.7; < 0.0001) and 6 months (36.0 +/- 4.9 vs 34.6 +/- 6.4; = 0.05). The Home group demonstrated a greater improvement in health-related quality of life (physical) by 6 months in comparison to the Hosp patients (51.2 +/- 6.4 vs 48.6 +/- 7.1; = 0.004). CONCLUSION: This study suggests that low-risk CABG surgery patients may be served as well or better with a monitored, home-based exercise program than with an institution-based program.

Coronary Disease↗
PubMed2002

[Peripheral muscle dysfunction in chronic obstructive pulmonary disease].

Patients with chronic obstructive pulmonary disease (COPD) often develop systemic complications of their disease. Peripheral muscle dysfunction is one such complication and is characterised by atrophy, weakness, and low oxidative capacity. These muscle changes influence exercise tolerance and quality of life independent of the impairment in lung function. In the following article, the evidence for peripheral muscle dysfunction in patients with COPD and the possible clinical implications of this problem will be discussed. Lastly, the available therapeutic options to improve peripheral muscle function in COPD will be reviewed.

Activities of Daily Living↗
PubMed2005

[Does the method of treatment in patients with an acute myocardial infarction influence the results of an early cardiac rehabilitation?].

UNLABELLED: Does the method of treatment in patients with an acute myocardial infarction influence the results of an early cardiac rehabilitation? Post-myocardial infarction recovery depends on various complimentary factors. The aim of this study was to evaluate whether the type of reperfusion in an acute myocardial infarction (MI) - primary angioplasty (PCI) or fibrinolysis - influence the recovery period and the final result of an early cardiac rehabilitation. METHODS: Retrospective analysis of case histories of 60 patients undergoing reperfusion procedures for an acute myocardial infarction was performed 30 pts (mean age 56 (9) were treated with fibrinolysis (group I) and 30 pts (mean age 53 (7) with PCI (group II). All the patients underwent cardiac rehabilitation in postMI period according to Rudnicki's model A and B. ECG exercise test was performed before start of rehabilitation and at the end. RESULTS: In both groups a significant prolongation of exercise test duration (0.89 and 1.13 min, p<0.005) as well as an increase in exercise capacity (0.86 and 0.96 METS, p<0.005) were observed. Both exercise duration time as well as maximum workload achieved did not differ among two groups at the beginning and at the end of cardiac rehabilitation. Independently on the reperfusion strategy used no significant differences were noted between two groups in the setting of all studied parameters. CONCLUSIONS: Early cardiac stationary rehabilitation in postMI patients leads to a significant improvement in physical capacity expressed as an increase in exercise ECG test duration and workload achieved. The method of reperfusion, if successful, does not influence the final result of rehabilitation.

Adult↗
PubMedDate not supplied

The Fibromyalgia Impact Questionnaire: a validated Spanish version to assess the health status in women with fibromyalgia.

OBJECTIVE: To translate, adapt, validate and assess the sensitivity to change of a Spanish version of the Fibromyalgia Impact Questionnaire (FIQ-S). METHODS: The FIQ-S was adapted following the translation and back-translation methodology. Female patients with fibromyalgia (FM) were invited to participate. Reliability was analyzed by the Spearman correlation coefficient between test and retest. Internal consistency was checked by the Cronbach's alpha coefficient. Construct validity was analyzed comparing FIQ-S with: HAQ, FHAQ, SF-36, SCL90-R, and the visual analogue scale for pain. Sensitivity to change was assessed in an 8-week randomized trial of exercise therapy. Feasibility was analyzed by the time taken in completing the FIQ-S and the proportion of patients able to complete the questionnaire. RESULTS: Translation was concordant. Adaptation affected at 4 sub-items of physical function. One-hundred and two FM patients completed the protocol. Mean age was 48.7 years with a mean of 9.2 years of evolution. Test-retest correlations were between 0.61-0.85 (p < 0.0001). Internal consistency showed alpha = 0.82 for all items and alpha = 0.86 for the sub-items of physical function. Significant correlations (p < 0.0001) were found between the FIQ-S items and HAQ, FHAQ, SF-36 and SCL90-R. For patients treated with the exercise program, the pre-treatment FIQ-S score was 52.0 +/- 11.5 and the post-treatment score was 40.8 +/- 13.7 (p < 0.003). Mean time for completing FIQ-S was 3.3 minutes. In 4% of the patients external help was needed. CONCLUSION: The FIQ-S is a reliable, valid and responsive to changes questionnaire for measuring health status and physical function in Spanish speaking FM patients.

Adult↗
PubMed2000

A virtual-reality-based telerehabilitation system with force feedback.

A PC-based orthopedic rehabilitation system was developed for use at home, while allowing remote monitoring from the clinic. The home rehabilitation station has a Pentium II PC with graphics accelerator, a Polhemus tracker, and a multipurpose haptic control interface. This novel interface is used to sample a patient's hand positions and to provide resistive forces using the Rutgers Master II (RMII) glove. A library of virtual rehabilitation routines was developed using WorldToolKit software. At the present time, it consists of three physical therapy exercises (DigiKey, ball, and power putty) and two functional rehabilitation exercises (peg board and ball game). These virtual reality exercises allow automatic and transparent patient data collection into an Oracle database. A remote Pentium II PC is connected with the home-based PC over the Internet and an additional video conferencing connection. The remote computer is running an Oracle server to maintain the patient database, monitor progress, and change the exercise level of difficulty. This allows for patient progress monitoring and repeat evaluations over time. The telerehabilitation system is in clinical trails at Stanford Medical School (CA), with progress being monitored from Rutgers University (NJ). Other haptic interfaces currently under development include devices for elbow and knee rehabilitation connected to the same system.

Computer Graphics↗
PubMed2005

Exercise-induced changes of the upper extremity in chronic stroke survivors.

Problems with daily activities due to decreased aerobic capacity and decreased strength are common in people who survive a stroke. Implementation of exercise for the upper extremity is challenging because of weakness and other impairments that limit performance of exercise activities. Although maximal exercise testing protocols are difficult to administer, submaximal testing may be a safe and effective means for prescribing exercise. Research studies have demonstrated that people with stroke can improve aerobic capacity and upper extremity muscle strength with exercise intervention, although the number of randomized controlled trials is limited and this area requires further investigation.

Adult↗
PubMed2005

Disease-modifying therapies for osteoarthritis : current status.

Osteoarthritis, the most common form of arthritis, is a debilitating progressive disease principally affecting the elderly. Osteoarthritis therapy has evolved in the past few decades from symptomatic treatment to possible disease-modifying solutions. In this paper, the pathophysiology of osteoarthritis is first reviewed, including an examination of the mechanisms underlying osteoarthritis and discussions of the roles of cartilage, synovial fluid and subchondral bone. The remainder of the paper discusses therapeutic approaches in current use and those in development, with special attention given to pharmacological treatments. Current approaches to treating osteoarthritis--i.e. medications; nonpharmacological modalities, such as physical therapy, exercise, weight management and orthotics; and (as a last resort) surgery--focus on reducing pain and improving (or at least maintaining) mobility. Drugs currently used to treat osteoarthritis fall into several categories: analgesics, NSAIDs, cyclo-oxygenase-2 (COX-2) inhibitors, corticosteroids, viscosupplementation, and symptomatic slow-acting drugs ('nutraceuticals'). The analgesics (paracetamol [acetaminophen] and opiates) have demonstrated less symptomatic efficacy than NSAIDs, while the latter have displayed mixed results in terms of joint space narrowing. COX-2 inhibitors have been demonstrated to be equal to or superior to NSAIDs in effectiveness. However, once considered a safer alternative, COX-2 inhibitors have become the subject of intense scrutiny since recent clinical evidence has cast suspicion on their cardiovascular safety profile. Injectable therapies, such as corticosteroids and viscosupplementation have elicited favorable short-term response but no long-term structural modification. On the other hand, the slow-acting drugs, especially chondroitin and glucosamine sulfate, have shown promising results. Also reviewed are other established and experimental therapies that seek to modify and/or even reverse the course of osteoarthritis. These include such medications as colchicine, bisphosphonates and hormones; dietary therapeutics, such as ginger extract and green tea; and such truly experimental treatments as matrix metalloproteinase inhibitors, cytokines, nitric oxide, growth factors and gene therapy. Osteoarthritis continues to be a difficult disorder to treat, as there is no cure as such and current treatments focus mainly on relieving pain and maintaining joint function. The search nevertheless continues for management regimens that can slow, alter or reverse the degenerative processes of osteoarthritis.

Aged↗
PubMed1983

[Experience with the rehabilitation of stroke patients in a specialized rehabilitation polyclinic].

The success of treating 549 patients who had survived cerebral stroke and received a course of therapy at a specialized rehabilitation outpatient clinic has demonstrated the feasibility and efficacy of rehabilitation in outpatient conditions. Comparison of the results of treatment in the study (139 patients) and the control (100 patients) groups offers a good idea as to the social significance of such rehabilitation. 75.8% of the study patients admitted for treatment immediately after the acute stage of the disease were found capable of working (including subjects with minimal disability), whereas the corresponding figure in the control group was only 16%. A new organizational structure, a neurologic outpatient rehabilitation department, providing combined biological and psychosocial methods of treatment is discussed. The principles of the design of the therapeutic and restorative process including psycho- and physiotherapy, as well as special methods of exercise therapy and occupational therapy are presented.

Adult↗
PubMed1997

Training with supplemental oxygen in patients with COPD and hypoxaemia at peak exercise.

Supplemental oxygen has acute beneficial effects on exercise performance in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to investigate whether oxygen-supplemented training enhances the effects of training while breathing room air in patients with severe COPD. A randomized controlled trial was performed in 24 patients with severe COPD who developed hypoxaemia during incremental cycle exercise (arterial oxygen saturation (Sa,O2) <90% at peak exercise). All patients participated in an in-patient pulmonary rehabilitation programme of 10 weeks duration. They were assigned either to general exercise training while breathing room air (GET/RA group: forced expiratory volume in one second (FEV1) 38% of predicted; arterial oxygen tension (Pa,O2) 10.5 kPa at rest; Pa,O2 7.3 kPa at peak exercise), or to GET while breathing supplemental oxygen (GET/O2 group: FEV1 29% pred; Pa,O2 10.2 kPa at rest; Pa,O2 7.2 kPa at peak exercise). Sa,O2 was not allowed to fall below 90% during the training. The effects on exercise performance while breathing air and oxygen, and on quality of life were compared. Maximum workload (Wmax) significantly increased in the GET/RA group (mean (SD) 17 (15) W, p<0.01), but not in the GET/O2 group (7 (25) W). Six minute walking distance (6MWD), stair-climbing, weight-lifting exercise (all while breathing room air) and quality of life significantly increased in both groups. Acute administration of oxygen improved exercise performance before and after training. Training significantly increased Wmax, peak carbon dioxide production (V'CO2) and 6MWD while breathing oxygen in both groups. Differences between groups were not significant. Pulmonary rehabilitation improved exercise performance and quality of life in both groups. Supplementation of oxygen during the training did not add to the effects of training on room air.

Exercise Therapy↗
PubMed1986

[Urodynamic and roentgenologic findings before and following complex physical therapy of urinary incontinence in the female].

In 42 patients complaints following therapy have been correlated to the pretherapeutic urodynamic findings and in 58 patients pre- and posttherapeutic urometric and X-ray findings have been compared independent from subjective result in oder to have objective parameters for the effectivity of conservative treatment of urinary incontinence. The best results could be achieved, if in the starting urometry the pressure transmission was bad and the dosing pressure of the urethra in rest adequate to the age. In analogy about identic urethral closing pressure in rest, but significant increase of the functional urethral length and a better pressure transmission in a sitting position could be found. Good results of conservative treatment on urge incontinence symptomatology could be derived from increasing bladder capacity and compliance. Against it a posttherapeutic increase of urinary incontinence signs by training-effects of exercise therapy has to be stated in the comparison of X-rays. Altogether the high rate of 63 per cent curing and 20 per cent improvement could not be detached sufficiently by urometric and radiography findings. This discrepancy has been discussed.

Female↗
PubMed2005

Intermittent claudication: an overview.

Intermittent claudication (IC) is defined by leg muscle pain, cramping and fatigue brought on by ambulation/exercise; relieved on rest; and caused by inadequate blood supply and is the primary symptom of peripheral arterial disease (PAD). PAD has a detrimental effect on the quality of life. PAD is a debilitating atherosclerotic disease of the lower limbs and is associated with an increased risk of cardiovascular morbidity and mortality. IC is an extremely important marker of atheroma. Up to 60% patients with IC have significant underlying coronary and/or carotid disease and 40% of all patients suffering from IC die or suffer a stroke within 5 years of presentation. The therapeutic intervention of IC essentially aims at providing symptomatic relief and reducing the systemic cardiovascular complications. Although exercise therapy is one of the most efficacious conservative treatments for claudication, the pharmacotherapeutic goals can be best achieved through an increase in the walking capacity to improve quality of life and a decrease in rates of amputation. In the development of treatment for IC, an aggressive non-pharmacological intervention and pharmacological treatment of the risk factors associated with IC are considered. In the next 2 years, the results of major trials of drugs that stabilize and regress atherosclerosis such as statins and angiotensin converting enzyme inhibitors, and anti-platelet agents, recombinant growth factors and immune modulators will be available for IC. Levocarnitine (l-carnitine) and a derivative, propionyl levocarnitine, are emerging agents that increase the pain-free walking and improve the quality of life in IC patients by working at the metabolism and exercise performance of ischemic muscles. This article provides a comprehensive review of the pathophysiology involved, diagnosis of IC and existing and emerging pharmacotherapies with rationale for their use in its treatment.

Humans↗
PubMed1991

[Sports in ankylosing spondylitis].

As therapy of ankylosing spondylarthritis still remains empirical, gymnastics and sports are of particular importance within the treatment of this disease. They aim at the improvement or at least the preservation of mobility, force and endurance. By those means an eventual immobilisation of the axial skeleton or the peripheral joints should take place in a position as favourable to function as possible. Various joint mobilisation techniques as well as muscle stretching are used to improve mobility. The latter thus pointedly prevents muscular disbalances. Various training methods are able to improve muscular performance. Slow dynamic force training can be used in gymnastic lessons as well as in home programmes. Maximal and staying power can thus be increased. Aerobic muscular training favours general efficiency, has a positive influence on risk factors of cardiac and vascular diseases and improves thoracic excursion. Motivation of the patient is correlated with the diversion of exercise, therapies and sport activities. The suitability of these measures are to be judged by expected maximal strain, the control of motion pattern, the effect of external forces as well as by the hazard to fall. Each and every sport activity has to be accompanied by supportive gymnastics. The most important sport disciplines are evaluated.

Gymnastics↗
PubMedDate not supplied

[Post-mastectomy lymphedema: surgical therapy].

After some preliminary remarks concerning epidemiological data about post-mastectomy lymphedema, on the basis of specific etiologic and pathophysiologic aspects, authors report a modern clinical and instrumental staging of lymphedema and an accurate diagnostic protocol, which allows not only to study lymphedema at late stages, but also to individuate the disease at earliest stages. Protocols of medical, physical and rehabilitative treatment mostly used today are schematically described, and they include proper igienic measures for the prevention bacterial and micotic infections, manual lymph drainage, sequential compression therapy, exercises, thermotherapy, bandages and elastic garments. Authors underline above all the importance of Microsurgery in treating post-mastectomy lymphedema, by means of modern methods of lymphatic microsurgery, derivative or reconstructive (multiple lymphatic-venous anastomoses, lymphatic-venous-lymphatic plasty). The operation of multiple lymphatic-venous anastomoses represent the mostly used technique. The registry consists of 194 microsurgical operations, performed in patients treated and followed-up statistically in the last 15 years, with positive result in over 80% of cases.

Arm↗